Provider Demographics
NPI:1649556515
Name:RINEHART, MORRIS DAVID II (IDC)
Entity Type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:DAVID
Last Name:RINEHART
Suffix:II
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3D RECON BN
Mailing Address - Street 2:UNIT 36180
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96602-6180
Mailing Address - Country:US
Mailing Address - Phone:315-625-2480
Mailing Address - Fax:
Practice Address - Street 1:3D RECON BN
Practice Address - Street 2:UNIT 36180
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96602-6180
Practice Address - Country:US
Practice Address - Phone:315-625-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05103602MR1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman