Provider Demographics
NPI:1326151010
Name:REED DERMATOLOGY CLINIC PA
Entity Type:Organization
Organization Name:REED DERMATOLOGY CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:N
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-322-7546
Mailing Address - Street 1:1870 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-1853
Mailing Address - Country:US
Mailing Address - Phone:828-322-7546
Mailing Address - Fax:828-322-9927
Practice Address - Street 1:1870 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1853
Practice Address - Country:US
Practice Address - Phone:828-322-7546
Practice Address - Fax:828-322-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24612207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012F6OtherBCBS OF NORTH CAROLINA
NC8970788Medicaid
NC8970788Medicaid