Provider Demographics
NPI:1568844082
Name:REAP, LEO EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:EDWARD
Last Name:REAP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31500 TELEGRAPH RD STE 225
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4315
Mailing Address - Country:US
Mailing Address - Phone:248-552-0620
Mailing Address - Fax:
Practice Address - Street 1:31500 TELEGRAPH RD STE 225
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4315
Practice Address - Country:US
Practice Address - Phone:248-552-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-20
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine