Healthcare Provider Details

I. General information

NPI: 1588628820
Provider Name (Legal Business Name): CHRISTOPHER ANDREW REEDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6728 LOOP RD BLDG 5, SUITE 301
DAYTON OH
45459-2196
US

IV. Provider business mailing address

6728 LOOP RD BLDG 5, SUITE 301
DAYTON OH
45459-2196
US

V. Phone/Fax

Practice location:
  • Phone: 937-438-5333
  • Fax: 937-438-0160
Mailing address:
  • Phone: 937-438-5333
  • Fax: 937-438-0160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number31005419R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: