Healthcare Provider Details

I. General information

NPI: 1821180811
Provider Name (Legal Business Name): MICHELLE D. REID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE STREET, EMORY UNIVERSITY HOSPITAL MIDTOWN DEPARTMENT OF PATHOLOGY, DAVIS FISCHER BLDG, ROOM 1325
ATLANTA GA
30308-0004
US

IV. Provider business mailing address

1889 RIDGEMONT LN
DECATUR GA
30033-4051
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-1995
  • Fax: 404-686-4978
Mailing address:
  • Phone: 404-806-1478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number056354
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: