Healthcare Provider Details

I. General information

NPI: 1750618427
Provider Name (Legal Business Name): CAROL M. REID, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2009
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE STE 200
DENVER CO
80220-3909
US

IV. Provider business mailing address

4545 E 9TH AVE STE 200
DENVER CO
80220-3909
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-5516
  • Fax:
Mailing address:
  • Phone: 303-320-5516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number32224
License Number StateCO

VIII. Authorized Official

Name: CAROL REID
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 303-320-5516