Provider Demographics
NPI:1497887624
Name:REINER, SETH D (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:D
Last Name:REINER
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:PO BOX 910779
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-0779
Mailing Address - Country:US
Mailing Address - Phone:303-778-5714
Mailing Address - Fax:303-778-5293
Practice Address - Street 1:2555 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5855
Practice Address - Country:US
Practice Address - Phone:303-778-5714
Practice Address - Fax:303-778-5293
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO318002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01318021Medicaid
CO01318021Medicaid
C29849Medicare PIN
COF29849Medicare UPIN