MEDICARE: DR. DAVID M REINGOLD 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
1	207R00000X	Internal Medicine Physician	020144	GA

General Provider Information

NPI Number	:	1598779779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M REINGOLD M.D.

Provider Business Mailing Address
First Line	:	4235 JOHNS CREEK PKWY
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-6038
Country	:	US
Telephone Number	:	770-442-1911
Fax Number	:	770-663-8905

Provider Business Practice Location Address
First Line	:	4235 JOHNS CREEK PKWY
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-6038
Country	:	US
Telephone Number	:	770-476-2733
Fax Number	:	770-476-1929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	01/14/2009

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