Provider Demographics
NPI:1710087192
Name:REID, MARIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 N ELAM AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1152
Mailing Address - Country:US
Mailing Address - Phone:336-235-3060
Mailing Address - Fax:336-235-3079
Practice Address - Street 1:526 N ELAM AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1152
Practice Address - Country:US
Practice Address - Phone:336-235-3060
Practice Address - Fax:336-235-3079
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16708Medicare UPIN