Healthcare Provider Details

I. General information

NPI: 1750371795
Provider Name (Legal Business Name): GARY CRAIG REID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 01/05/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 THOMAS LN STE 3B
COLUMBUS OH
43214-3902
US

IV. Provider business mailing address

1299 OLENTANGY RIVER RD STE 103
COLUMBUS OH
43212-3118
US

V. Phone/Fax

Practice location:
  • Phone: 614-538-0440
  • Fax: 614-538-0443
Mailing address:
  • Phone: 614-566-4278
  • Fax: 614-566-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number35056802R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: