Healthcare Provider Details

I. General information

NPI: 1922291921
Provider Name (Legal Business Name): GERALD M REED, D.O.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 W 7TH ST
FREDERICK MD
21701-4689
US

IV. Provider business mailing address

27 W 7TH ST
FREDERICK MD
21701-4689
US

V. Phone/Fax

Practice location:
  • Phone: 301-694-9111
  • Fax:
Mailing address:
  • Phone: 301-694-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberHOO16396
License Number State

VIII. Authorized Official

Name: DR. GERALD MARTIN REED
Title or Position: PRESIDENT
Credential: D.O.
Phone: 301-253-5599