Provider Demographics
NPI:1205000882
Name:REINERT, SHAWN DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:DAVID
Last Name:REINERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 PINNELL ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-9101
Mailing Address - Country:US
Mailing Address - Phone:304-372-2731
Mailing Address - Fax:304-372-2749
Practice Address - Street 1:3200 MACCORKLE AVE SE
Practice Address - Street 2:HOSPITALISTS PROGRAM
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1227
Practice Address - Country:US
Practice Address - Phone:304-388-5848
Practice Address - Fax:304-388-9654
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2558207R00000X, 208M00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810024955Medicaid
WVP01063338OtherMEDICARE RAILROAD
WVP01063338OtherMEDICARE RAILROAD