Healthcare Provider Details

I. General information

NPI: 1902851868
Provider Name (Legal Business Name): SEAN M REES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S DAISY ST
SALMON ID
83467-4709
US

IV. Provider business mailing address

203 S DAISY ST
SALMON ID
83467-4709
US

V. Phone/Fax

Practice location:
  • Phone: 208-756-5655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00036874
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: