Provider Demographics
NPI:1568753762
Name:REIGEL, DAVID GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GEORGE
Last Name:REIGEL
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 1:15247 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5013
Mailing Address - Country:US
Mailing Address - Phone:425-643-8920
Mailing Address - Fax:
Practice Address - Street 1:15247 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-5013
Practice Address - Country:US
Practice Address - Phone:425-643-8920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00010446208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics