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NPI Code Detail

MEDICARE: KEITH CHRISTIAN RESCHLY M.D.

MEDICARE: KEITH CHRISTIAN RESCHLY 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
1207Q00000XFamily Medicine Physician32841NC
2208M00000XHospitalist Physician32841NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598762114
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH CHRISTIAN RESCHLY M.D.
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 910-721-2070
Fax Number : 910-721-2074
Provider Business Practice Location Address
First Line : 240 HOSPITAL DR NE
Second Line :
City : BOLIVIA
State : NC
Zip : 28422-8346
Country : US
Telephone Number : 910-721-2070
Fax Number : 107-212-0749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2005
Last Update Date : 10/25/2020

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