Healthcare Provider Details

I. General information

NPI: 1437101250
Provider Name (Legal Business Name): STEPHEN D. REINHARDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 WADSWORTH DR
NORTH CHESTERFIELD VA
23236-4510
US

IV. Provider business mailing address

229 WADSWORTH DR
NORTH CHESTERFIELD VA
23236-4510
US

V. Phone/Fax

Practice location:
  • Phone: 804-228-3627
  • Fax: 804-560-1312
Mailing address:
  • Phone: 804-228-3627
  • Fax: 804-560-1312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101034345
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: