MEDICARE: DR. PAMELA REAVES MD

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	4301056648	MI

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	:	1952340804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA REAVES MD

Provider Business Mailing Address
First Line	:	PO BOX 321061
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48232-1061
Country	:	US
Telephone Number	:	248-543-8070
Fax Number	:	248-543-9005

Provider Business Practice Location Address
First Line	:	20176 LIVERNOIS AVE
Second Line	:	SUITE 101
City	:	DETROIT
State	:	MI
Zip	:	48221-1346
Country	:	US
Telephone Number	:	313-927-0000
Fax Number	:

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	05/29/2026

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Directions to “ DR. PAMELA REAVES MD” Practice Location

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