Provider Demographics
NPI:1356511679
Name:MICHAEL C. REINECK, MD
Entity Type:Organization
Organization Name:MICHAEL C. REINECK, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:REINECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-306-8820
Mailing Address - Street 1:PO BOX 713
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-0713
Mailing Address - Country:US
Mailing Address - Phone:262-306-8931
Mailing Address - Fax:
Practice Address - Street 1:1201 OAK ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-3800
Practice Address - Country:US
Practice Address - Phone:262-306-8820
Practice Address - Fax:262-306-8931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31207000Medicaid
WI31207000Medicaid
WIB55995Medicare UPIN
WI67022Medicare PIN