Healthcare Provider Details

I. General information

NPI: 1942527551
Provider Name (Legal Business Name): DAVID G. REED, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7087 WEST BOULEVARD
YOUNGSTOWN OH
44512
US

IV. Provider business mailing address

7087 WEST BOULEVARD
YOUNGSTOWN OH
44512
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-0591
  • Fax: 330-758-8491
Mailing address:
  • Phone: 330-758-0591
  • Fax: 330-758-8491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number35-026773-R
License Number StateOH

VIII. Authorized Official

Name: DAVID GEORGE REED
Title or Position: PRESIDENT DAVID G. REED, MD, INC
Credential: MD
Phone: 330-758-0591