Provider Demographics
NPI:1225359813
Name:MARTHA A. REED M.D., INC.
Entity Type:Organization
Organization Name:MARTHA A. REED M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-586-6820
Mailing Address - Street 1:11318 HIGHWAY 21
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-5207
Mailing Address - Country:US
Mailing Address - Phone:636-586-6820
Mailing Address - Fax:636-586-6821
Practice Address - Street 1:11318 HIGHWAY 21
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-5207
Practice Address - Country:US
Practice Address - Phone:636-586-6820
Practice Address - Fax:636-586-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6891207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200006906Medicaid
MO000005196Medicare PIN
MO200006906Medicaid