Provider Demographics
NPI:1467708206
Name:REYES, LORETTA (MD)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1400 TULLIE RD NE FL 2
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2309
Mailing Address - Country:US
Mailing Address - Phone:404-785-5437
Mailing Address - Fax:404-785-9071
Practice Address - Street 1:1400 TULLIE RD NE FL 2
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2309
Practice Address - Country:US
Practice Address - Phone:404-785-5437
Practice Address - Fax:404-785-9071
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2022-06-06
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Provider Licenses
StateLicense IDTaxonomies
GA761492080P0210X, 2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology