Provider Demographics
NPI:1447220223
Name:REEL, MICHAEL IAN (APN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:IAN
Last Name:REEL
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:IAN
Other - Last Name:REEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:4903 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817
Mailing Address - Country:US
Mailing Address - Phone:501-868-8979
Mailing Address - Fax:
Practice Address - Street 1:4903 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817
Practice Address - Country:US
Practice Address - Phone:501-257-5117
Practice Address - Fax:501-257-5056
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAO1221 ANP363LF0000X
MDAC001526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily