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General NPI Number Information
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NPI Number | 1205464971
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Entity Type | Individual
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Provider Name | CHRISTOPHER VELEZ REYES MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 3000 SHAKERAG HL
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-3365
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Country | US
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Telephone | 404-251-2150
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Fax | 770-632-6189
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Provider Business Mailing Address
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Address Line | 105 IVER PL APT 305
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4606
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Country | US
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Telephone | 908-723-9969
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 96860
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License Number State | GA
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