MEDICARE: DR. RUSSELL GEORGE REITINGER 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	207V00000X	Obstetrics & Gynecology Physician	28154	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1750467213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSSELL GEORGE REITINGER M.D.

Provider Business Mailing Address
First Line	:	2030 MOUNTAIN VIEW AVE
Second Line	:	SUITE 400
City	:	LONGMONT
State	:	CO
Zip	:	80501-3182
Country	:	US
Telephone Number	:	303-702-5910
Fax Number	:	303-702-5935

Provider Business Practice Location Address
First Line	:	2030 MOUNTAIN VIEW AVENUE
Second Line	:	SUITE 400
City	:	LONGMONT
State	:	CO
Zip	:	80501-3182
Country	:	US
Telephone Number	:	303-702-5910
Fax Number	:	303-702-5935

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	01/23/2015

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