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NPI Code Detail

MEDICARE: DR. PAUL I REISS DPM

MEDICARE:  DR. PAUL I REISS  DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist103NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
208145OTHERNCBCBS

General Provider Information

NPI Number : 1093799835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL I REISS DPM
Provider Business Mailing Address
First Line : 4915 ALBEMARLE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205-6617
Country : US
Telephone Number : 704-568-5444
Fax Number : 704-568-5445
Provider Business Practice Location Address
First Line : 4915 ALBEMARLE RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28205-6617
Country : US
Telephone Number : 704-568-5444
Fax Number : 704-568-5445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 07/09/2007

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Directions to “ DR. PAUL I REISS DPM” Practice Location

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