Healthcare Provider Details

I. General information

NPI: 1700978665
Provider Name (Legal Business Name): DAVID REITER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CHESTNUT ST 6TH FLOOR
PHILADELPHIA PA
19107-4216
US

IV. Provider business mailing address

PO BOX 770
NARBERTH PA
19072-0770
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8682
  • Fax: 215-955-1428
Mailing address:
  • Phone: 610-667-0125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD016631E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: