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NPI Code Detail

MEDICARE: DR. RICHARD G. REBER M.D.

MEDICARE:  DR. RICHARD G. REBER  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
12085R0202XDiagnostic Radiology Physician103708MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116-02601OTHERUNITED HEALTHCARE

General Provider Information

NPI Number : 1730173964
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD G. REBER M.D.
Provider Business Mailing Address
First Line : PO BOX 802758
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-0001
Country : US
Telephone Number : 314-645-4900
Fax Number : 314-645-6548
Provider Business Practice Location Address
First Line : 1500 N OAKLAND AVE
Second Line : DEPT. OF RADIOLOGY
City : BOLIVAR
State : MO
Zip : 65613-3011
Country : US
Telephone Number : 417-328-6446
Fax Number : 417-328-6369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 07/09/2007

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Directions to “ DR. RICHARD G. REBER M.D.” Practice Location

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