Provider Demographics
NPI:1447208525
Name:REITER, EVAN RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:RALPH
Last Name:REITER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1201 E MARSHALL ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-2050
Mailing Address - Country:US
Mailing Address - Phone:804-828-2766
Mailing Address - Fax:804-828-3495
Practice Address - Street 1:1201 E MARSHALL ST
Practice Address - Street 2:SUITE 410
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-2050
Practice Address - Country:US
Practice Address - Phone:804-828-2766
Practice Address - Fax:804-828-3495
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101057271207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology