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NPI Code Detail

MEDICARE: MR. DAVID R. REITTER MD

MEDICARE: MR. DAVID R. REITTER MD
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
1208600000XSurgery PhysicianDR.50480CO
2208600000XSurgery Physician44809MN

Other Identifiers

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

General Provider Information

NPI Number : 1639156177
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID R. REITTER MD
Provider Business Mailing Address
First Line : 410 BENEDICTA AVE
Second Line :
City : TRINIDAD
State : CO
Zip : 81082-2005
Country : US
Telephone Number : 719-846-9213
Fax Number : 719-846-2752
Provider Business Practice Location Address
First Line : 410 BENEDICTA AVE
Second Line :
City : TRINIDAD
State : CO
Zip : 81082-2005
Country : US
Telephone Number : 719-846-9213
Fax Number : 719-846-2752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 10/10/2018

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