Provider Demographics
NPI:1740575190
Name:REISS, ALISHA DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:DAWN
Last Name:REISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:DAWN
Other - Last Name:FLATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:835 SWEITZER ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1077
Mailing Address - Country:US
Mailing Address - Phone:937-569-6937
Mailing Address - Fax:
Practice Address - Street 1:804 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1206
Practice Address - Country:US
Practice Address - Phone:937-547-0107
Practice Address - Fax:937-547-0335
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTRAINING208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery