Healthcare Provider Details

I. General information

NPI: 1134103385
Provider Name (Legal Business Name): INEZ VERA REEVES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW STE 3300
WASHINGTON DC
20060
US

IV. Provider business mailing address

2041 GEORGIA AVE NW TOWER 6101
WASHINGTON DC
20060-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-8653
  • Fax: 202-865-4589
Mailing address:
  • Phone: 202-865-6679
  • Fax: 202-865-3138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberD0057942
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD037191
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: