Provider Demographics
NPI:1124224506
Name:MICHAEL D. REINER, MD, PC
Entity Type:Organization
Organization Name:MICHAEL D. REINER, MD, PC
Other - Org Name:FAMILY PHYSICIANS OF SOUTHERN NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:REINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-751-6111
Mailing Address - Street 1:1470 E CALVADA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-3905
Mailing Address - Country:US
Mailing Address - Phone:702-751-6111
Mailing Address - Fax:775-751-6115
Practice Address - Street 1:1470 E CALVADA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3905
Practice Address - Country:US
Practice Address - Phone:702-751-6111
Practice Address - Fax:775-751-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10499261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP34428Medicare UPIN
NVR27603Medicare UPIN
NVF00999Medicare UPIN