Provider Demographics
NPI:1497848550
Name:REEVES, RALPH M (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:M
Last Name:REEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 RIDGEWOOD ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-6977
Mailing Address - Country:US
Mailing Address - Phone:610-378-9601
Mailing Address - Fax:610-378-3610
Practice Address - Street 1:2201 RIDGEWOOD ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-6977
Practice Address - Country:US
Practice Address - Phone:610-378-9601
Practice Address - Fax:610-378-3610
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No273R00000XHospital UnitsPsychiatric UnitGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103370Medicare PIN
PA103370XTGMedicare PIN
PAC30068Medicare UPIN