MEDICARE: DR. DIANA REEVES M.D.

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
1	207W00000X	Ophthalmology Physician	43717	CO
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	43717	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PO0690573	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1386625044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA REEVES M.D.

Provider Business Mailing Address
First Line	:	4500 CHERRY CREEK DRIVE SOUTH
Second Line	:	SUITE 102
City	:	DENVER
State	:	CO
Zip	:	80246-1532
Country	:	US
Telephone Number	:	303-220-0393
Fax Number	:	303-740-5865

Provider Business Practice Location Address
First Line	:	4500 CHERRY CREEK DRIVE SOUTH
Second Line	:	SUITE 102
City	:	DENVER
State	:	CO
Zip	:	80246-1518
Country	:	US
Telephone Number	:	303-220-0393
Fax Number	:	303-740-5865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/12/2022

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