Healthcare Provider Details
I. General information
NPI: 1598764904
Provider Name (Legal Business Name): PATRICIA NEYLAND REAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 07/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9407 CUMBERLAND RD
NEW KENT VA
23124-2029
US
IV. Provider business mailing address
9407 CUMBERLAND RD
NEW KENT VA
23124-2029
US
V. Phone/Fax
- Phone: 804-966-2242
- Fax: 804-966-5639
- Phone: 804-966-2242
- Fax: 804-966-5639
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 0101029182 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: