MEDICARE: DR. LAURIE BETH REEDER 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	208600000X	Surgery Physician	D0062390	MD
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	D0062390	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CC1923	OTHER	MD	R/R MEDICARE GROUP #
2	P00201295	OTHER	MD	R/R MEDICARE PROVIDER #

General Provider Information

NPI Number	:	1740222744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIE BETH REEDER M.D.

Provider Business Mailing Address
First Line	:	1351 S COUNTY TRL
Second Line	:	SUITE 200B
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-5079
Country	:	US
Telephone Number	:	401-886-0923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 S COUNTY TRL
Second Line	:	SUITE 200B
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-5079
Country	:	US
Telephone Number	:	401-886-0923
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	03/06/2008

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Directions to “ DR. LAURIE BETH REEDER M.D.” Practice Location

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