Provider Demographics
NPI:1629082482
Name:REED, MARIA E (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:REED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:BRYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-353-3102
Mailing Address - Fax:517-353-3101
Practice Address - Street 1:4660 S HAGADORN RD STE 230
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5353
Practice Address - Country:US
Practice Address - Phone:517-353-3102
Practice Address - Fax:517-353-3101
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003788363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N46330Medicare ID - Type Unspecified