Provider Demographics
NPI:1922323138
Name:REICHARD, STEPHEN GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GEORGE
Last Name:REICHARD
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 1:536 S COTTONWOOD RD
Mailing Address - Street 2:STE 100
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9529
Mailing Address - Country:US
Mailing Address - Phone:406-586-8029
Mailing Address - Fax:
Practice Address - Street 1:738 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5238
Practice Address - Country:US
Practice Address - Phone:252-634-2676
Practice Address - Fax:252-638-1765
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137076207X00000X
NC2016-01717207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery