NPI Code Details Logo

NPI 1760293419

NPI 1760293419 : DONALD REESE : GLENN DALE, MD

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1760293419
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DONALD REESE
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/14/2025
-----------------------------------------------------
    Last Update Date     |    01/14/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    11732 WYNNIFRED PL 
-----------------------------------------------------
    City                 |    GLENN DALE
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20769-9482
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    443-744-0571
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    11732 WYNNIFRED PL 
-----------------------------------------------------
    City                 |    GLENN DALE
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20769-9482
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    443-744-0571
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    183500000X
-----------------------------------------------------
    Taxonomy Name        |    Pharmacist
-----------------------------------------------------
    License Number       |    0202207736
-----------------------------------------------------
    License Number State |    VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    183500000X
-----------------------------------------------------
    Taxonomy Name        |    Pharmacist
-----------------------------------------------------
    License Number       |    14979
-----------------------------------------------------
    License Number State |    MD
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.