Healthcare Provider Details

I. General information

NPI: 1023093697
Provider Name (Legal Business Name): ELIZABETH MARGARET REINOEHL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10243 ROGERS DRIVE
NASSAWADOX VA
23413-0836
US

IV. Provider business mailing address

POST OFFICE BOX 836
NASSAWADOX VA
23413-0836
US

V. Phone/Fax

Practice location:
  • Phone: 757-442-6719
  • Fax: 757-442-7375
Mailing address:
  • Phone: 757-442-6719
  • Fax: 757-442-7375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number200000592
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0102202142
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: