Healthcare Provider Details
I. General information
NPI: 1952621443
Provider Name (Legal Business Name): CHRISTOPHER REEDER & ASSOCIATES PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2010
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6728 LOOP RD BLDG. 5, SUITE 301
CENTERVILLE OH
45459-2196
US
IV. Provider business mailing address
6728 LOOP RD BLDG. 5, SUITE 301
CENTERVILLE OH
45459-2196
US
V. Phone/Fax
- Phone: 937-438-5333
- Fax: 937-438-0160
- Phone: 937-438-5333
- Fax: 937-438-0160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0099X |
| Taxonomy | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0105X |
| Taxonomy | Surgery of the Hand (Plastic Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
ANDREW
REEDER
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 937-438-5333