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NPI Code Detail

MEDICARE: JAMES W REID JR. MD

MEDICARE: JAMES W REID JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist0101022154VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00162953OTHERVARAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1324502OTHERVAANTHEM BCBS

General Provider Information

NPI Number : 1255353470
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES W REID JR. MD
Provider Business Mailing Address
First Line : 11015 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-3225
Country : US
Telephone Number : 757-591-7291
Fax Number : 757-591-2125
Provider Business Practice Location Address
First Line : 11015 WARWICK BLVD
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23601-3225
Country : US
Telephone Number : 757-591-7291
Fax Number : 757-591-2125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 07/08/2007

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