Provider Demographics
NPI:1659498871
Name:REIHELD, ROBERT GALE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GALE
Last Name:REIHELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 QUEEN ANNE DR
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1758
Mailing Address - Country:US
Mailing Address - Phone:252-482-0624
Mailing Address - Fax:
Practice Address - Street 1:207 QUEEN ANNE DR
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1758
Practice Address - Country:US
Practice Address - Phone:252-482-0624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF04086Medicare UPIN