Healthcare Provider Details

I. General information

NPI: 1336646983
Provider Name (Legal Business Name): JESSICA REED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 105TH AVE
STANWOOD MI
49346-9764
US

IV. Provider business mailing address

20095 GILBERT RD
BIG RAPIDS MI
49307-2365
US

V. Phone/Fax

Practice location:
  • Phone: 231-592-1360
  • Fax:
Mailing address:
  • Phone: 231-592-1360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301510441
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: