Provider Demographics
NPI:1588628820
Name:REEDER, CHRISTOPHER ANDREW (DO)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:REEDER
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 1:6728 LOOP RD
Mailing Address - Street 2:BLDG 5, SUITE 301
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2196
Mailing Address - Country:US
Mailing Address - Phone:937-438-5333
Mailing Address - Fax:937-438-0160
Practice Address - Street 1:6728 LOOP RD
Practice Address - Street 2:BLDG 5, SUITE 301
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-2196
Practice Address - Country:US
Practice Address - Phone:937-438-5333
Practice Address - Fax:937-438-0160
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31005419R2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0847132Medicaid
OH0847132Medicaid
A66164Medicare UPIN