Provider Demographics
NPI:1437101250
Name:REINHARDT, STEPHEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:REINHARDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 WADSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4510
Mailing Address - Country:US
Mailing Address - Phone:804-228-3627
Mailing Address - Fax:804-560-1312
Practice Address - Street 1:229 WADSWORTH DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4510
Practice Address - Country:US
Practice Address - Phone:804-228-3627
Practice Address - Fax:804-560-1312
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0013OtherUNITED HEALTHCARE
VA2128667OtherMAMSI
VA249152OtherSOUTHERN HEALTH
VA540883363OtherPHCS
VA4063677OtherAETNA
VA540883363OtherFIRST HEALTH/CCN
VA540883363OtherPREFERRED CARE
VA95885OtherOPTIMA
VA540883363OtherCHAMPUS-TRICARE
VA540883363OtherGREAT WEST HEALTHCARE
VA540883363OtherVIRGINIA HEALTH NETWORK
VA1458163OtherCIGNA
VA158023OtherANTHEM
VA010115671Medicaid
VA540883363OtherGREAT WEST HEALTHCARE
VA006705V26Medicare PIN
VA95885OtherOPTIMA
VA010115671Medicaid
VA016215V27Medicare PIN