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General NPI Number Information
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NPI Number | 1144326810
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Entity Type | Individual
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Provider Name | MITCHELL W REIDER MD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 3909 ORANGE PL SUITE 2500
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City | BEACHWOOD
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State | OH
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Zip | 44122-4478
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Country | US
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Telephone | 216-896-1778
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Fax | 216-896-1780
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Provider Business Mailing Address
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Address Line | 3909 ORANGE PL SUITE 2500
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City | BEACHWOOD
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State | OH
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Zip | 44122-4478
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Country | US
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Telephone | 216-896-1778
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Fax | 216-896-1780
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35076274R
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License Number State | OH
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