Healthcare Provider Details

I. General information

NPI: 1306810429
Provider Name (Legal Business Name): MITCHELL S. REIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HUTCHINSON DR NSMC-WOMEN'S CENTER
DANVERS MA
01923-3759
US

IV. Provider business mailing address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

V. Phone/Fax

Practice location:
  • Phone: 978-739-6920
  • Fax:
Mailing address:
  • Phone: 978-744-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number56895
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number56895
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: