Provider Demographics
NPI:1275956328
Name:DAWN N REYNOLDS MD PC
Entity Type:Organization
Organization Name:DAWN N REYNOLDS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-443-8862
Mailing Address - Street 1:28545 ORCHARD LAKE RD STE A
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2996
Mailing Address - Country:US
Mailing Address - Phone:248-987-4060
Mailing Address - Fax:248-987-7012
Practice Address - Street 1:28545 ORCHARD LAKE RD STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2996
Practice Address - Country:US
Practice Address - Phone:248-987-4060
Practice Address - Fax:248-987-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty