MEDICARE: DR. SEAN C REEDER DO

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	207Q00000X	Family Medicine Physician	3530	AZ

General Provider Information

NPI Number	:	1437115599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN C REEDER DO

Provider Business Mailing Address
First Line	:	3933 E EDNA AVE
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2127
Country	:	US
Telephone Number	:	602-867-2219
Fax Number	:	602-867-1637

Provider Business Practice Location Address
First Line	:	3933 E EDNA AVE
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2127
Country	:	US
Telephone Number	:	602-867-2219
Fax Number	:	602-867-1637

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	11/29/2012

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