Provider Demographics
NPI:1598779779
Name:REINGOLD, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:REINGOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4235 JOHNS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6038
Mailing Address - Country:US
Mailing Address - Phone:770-442-1911
Mailing Address - Fax:770-663-8905
Practice Address - Street 1:4235 JOHNS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6038
Practice Address - Country:US
Practice Address - Phone:770-476-2733
Practice Address - Fax:770-476-1929
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2009-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA020144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD30592Medicare UPIN