MEDICARE: RICHARD A REID IDMT

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	1710I1003X	Independent Duty Medical Technicians

General Provider Information

NPI Number	:	1790126225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A REID IDMT

Provider Business Mailing Address
First Line	:	16015 GOOD MEADOW CT
Second Line	:
City	:	N POTOMAC
State	:	MD
Zip	:	20878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16015 GOOD MEADOW CT
Second Line	:
City	:	N POTOMAC
State	:	MD
Zip	:	20878
Country	:	US
Telephone Number	:	301-379-4140
Fax Number	:

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

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	07/12/2013

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Directions to “ RICHARD A REID IDMT” Practice Location

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