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General NPI Number Information
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NPI Number | 1457319543
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Entity Type | Individual
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Provider Name | MICHAEL J REYNOLDS MD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 4821 MONTGOMERY LN 801
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City | BETHESDA
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State | MD
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Zip | 20814-3471
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Country | US
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Telephone | 301-633-2801
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Fax |
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Provider Business Mailing Address
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Address Line | 4821 MONTGOMERY LN 801
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City | BETHESDA
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State | MD
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Zip | 20814-3471
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Country | US
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Telephone |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 31497
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD041534
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207LH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
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License Number | MD041534
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License Number State | DC
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