Healthcare Provider Details

I. General information

NPI: 1508015959
Provider Name (Legal Business Name): DAVID MANNING REED SR. MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 PEQUOT LN
NEW CANAAN CT
06840-2020
US

IV. Provider business mailing address

46 PEQUOT LN
NEW CANAAN CT
06840-2020
US

V. Phone/Fax

Practice location:
  • Phone: 203-966-1808
  • Fax: 203-966-1808
Mailing address:
  • Phone: 203-966-1808
  • Fax: 203-966-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number03-620982
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: