Provider Demographics
NPI:1497085229
Name:MICHAEL REINER MD PC
Entity Type:Organization
Organization Name:MICHAEL REINER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:REINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-354-8554
Mailing Address - Street 1:1260 BLACKHORN ST
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-8112
Mailing Address - Country:US
Mailing Address - Phone:702-354-8554
Mailing Address - Fax:
Practice Address - Street 1:1260 BLACKHORN ST
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-8112
Practice Address - Country:US
Practice Address - Phone:702-354-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10499208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty