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NPI Code Detail

MEDICARE: SHANE GREGORY REIGHARD M.D.

MEDICARE: SHANE GREGORY REIGHARD M.D.
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
1207R00000XInternal Medicine Physician90834SC
2207RC0000XCardiovascular Disease Physician90834SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SCR2029225OTHERSCMEDICARE PIN
2SCR2026084OTHERSCMEDICARE PIN
4SCR2023365OTHERSCMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588028880
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANE GREGORY REIGHARD M.D.
Provider Business Mailing Address
First Line : PO BOX 743070
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3070
Country : US
Telephone Number : 864-560-4304
Fax Number : 864-560-4413
Provider Business Practice Location Address
First Line : 1330 BOILING SPRINGS RD STE 2500
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-4214
Country : US
Telephone Number : 864-585-5433
Fax Number : 864-591-4053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2016
Last Update Date : 06/10/2024

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Directions to “ SHANE GREGORY REIGHARD M.D.” Practice Location

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