Provider Demographics
NPI:1598850141
Name:REIS, BRIJIT BERTSCHE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIJIT
Middle Name:BERTSCHE
Last Name:REIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIT
Other - Middle Name:MEEHAN
Other - Last Name:BERTSCHE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:30 AULIKE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2739
Mailing Address - Country:US
Mailing Address - Phone:808-263-8822
Mailing Address - Fax:808-261-6749
Practice Address - Street 1:30 AULIKE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2739
Practice Address - Country:US
Practice Address - Phone:808-263-8822
Practice Address - Fax:808-261-6749
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11900208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50832701Medicaid
47-0869423OtherTIN
HIG13587Medicare UPIN