Healthcare Provider Details

I. General information

NPI: 1083239081
Provider Name (Legal Business Name): MAX E REICHE II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 07/28/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR
TOLEDO OH
43606-3858
US

IV. Provider business mailing address

2109 HUGHES DR. 3RD FLOOR, JOBST TOWER
TOLEDO OH
43606
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-8154
  • Fax:
Mailing address:
  • Phone: 419-291-8154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number57.257157
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR-11978
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: