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General NPI Number Information
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NPI Number | 1962472712
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Entity Type | Individual
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Provider Name | REYNOLD RODNEY MARK D'LIMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 4881 SUGAR MAPLE DRIVE FAMILY PRACTICE, WRIGHT PATTERSON AIR FORCE BASE
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City | DAYTON
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State | OH
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Zip | 45433-5529
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Country | US
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Telephone | 513-417-2613
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Fax | 937-656-1843
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Provider Business Mailing Address
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Address Line | 4881 SUGAR MAPLE DRIVE FAMILY PRACTICE, WRIGHT PATTERSON AIR FORCE BASE
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City | DAYTON
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State | OH
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Zip | 45433-5529
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Country | US
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Telephone | 513-417-2613
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Fax | 937-656-1843
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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 | 00020783
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License Number State | AL
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