Healthcare Provider Details

I. General information

NPI: 1588052484
Provider Name (Legal Business Name): REED HALTERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2014
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 BAYTREE CT
AUGUSTA GA
30907-9131
US

IV. Provider business mailing address

974 HUNTING HORN WAY W
EVANS GA
30809-4828
US

V. Phone/Fax

Practice location:
  • Phone: 404-454-3401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN215584
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: