Provider Demographics
NPI:1407833205
Name:REISMAN, HOWARD ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ALAN
Last Name:REISMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11050 CRABAPPLE RD
Mailing Address - Street 2:SUITE 111D
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2489
Mailing Address - Country:US
Mailing Address - Phone:770-992-2691
Mailing Address - Fax:770-518-8042
Practice Address - Street 1:11050 CRABAPPLE RD
Practice Address - Street 2:SUITE 111D
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2489
Practice Address - Country:US
Practice Address - Phone:770-992-2691
Practice Address - Fax:770-518-8042
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2010-11-30
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Provider Licenses
StateLicense IDTaxonomies
GA021428207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D30593Medicare UPIN