Provider Demographics
NPI:1437411592
Name:REYES UMPIERREZ, DAVID ANTONIO (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANTONIO
Last Name:REYES UMPIERREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1800 HOWELL MILL ROAD NW
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2508
Mailing Address - Country:US
Mailing Address - Phone:404-355-4393
Mailing Address - Fax:404-609-7665
Practice Address - Street 1:1800 HOWELL MILL ROAD NW
Practice Address - Street 2:SUITE 450
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2508
Practice Address - Country:US
Practice Address - Phone:404-355-4393
Practice Address - Fax:404-609-7665
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA78115207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003193995AMedicaid