Provider Demographics
NPI:1821180811
Name:REID, MICHELLE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:D
Last Name:REID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1889 RIDGEMONT LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4051
Mailing Address - Country:US
Mailing Address - Phone:404-806-1478
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE STREET, EMORY UNIVERSITY HOSPITAL MIDTOWN
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY, DAVIS FISCHER BLDG, ROOM 1325
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-0004
Practice Address - Country:US
Practice Address - Phone:404-686-1995
Practice Address - Fax:404-686-4978
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA056354207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG56354Medicaid
GA236858668AMedicaid
GA236858668AMedicaid
I33679Medicare UPIN