Provider Demographics
NPI:1639453137
Name:REID, PETER C (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:C
Last Name:REID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RUSACRE ROAD
Mailing Address - Street 2:
Mailing Address - City:RONDEBOSCH
Mailing Address - State:OUTSIDE US AND CANADA
Mailing Address - Zip Code:7700
Mailing Address - Country:ZA
Mailing Address - Phone:021-685-3987
Mailing Address - Fax:021-685-3987
Practice Address - Street 1:8 RUSACRE ROAD
Practice Address - Street 2:
Practice Address - City:RONDEBOSCH
Practice Address - State:OUTSIDE US AND CANADA
Practice Address - Zip Code:7700
Practice Address - Country:ZA
Practice Address - Phone:021-685-3987
Practice Address - Fax:021-685-3987
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA339302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry