Healthcare Provider Details

I. General information

NPI: 1821090531
Provider Name (Legal Business Name): LAURA M REICH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3585 VAN TEYLINGEN DR SUITE E
COLORADO SPRINGS CO
80917-4875
US

IV. Provider business mailing address

3585 VAN TEYLINGEN DR SUITE E
COLORADO SPRINGS CO
80917-4875
US

V. Phone/Fax

Practice location:
  • Phone: 719-638-9772
  • Fax: 719-638-9914
Mailing address:
  • Phone: 719-638-9772
  • Fax: 719-638-9914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0026942
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: