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General NPI Number Information
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NPI Number | 1619597630
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Entity Type | Individual
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Provider Name | MEAGAN MARIE REINECKE DO
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Gender | Female
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 7903 PROVIDENCE RD STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28277-9763
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Country | US
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Telephone | 704-316-4460
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Fax | 704-316-4466
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 260750
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License Number State | NC
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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 | 2022-03347
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License Number State | NC
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