Provider Demographics
NPI:1740254655
Name:REEVES, CHRISTOPHER L (DPM)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:REEVES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:267-339-7843
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:1141 PATTERSON TER
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2203
Practice Address - Country:US
Practice Address - Phone:844-407-4070
Practice Address - Fax:407-743-3050
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3129213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340513300Medicaid
FLP00239123OtherR/R MEDICARE
FLV00180Medicare UPIN
FLU2551YMedicare PIN