Provider Demographics
NPI:1922427384
Name:REINERT, ROBERT CHARLES III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHARLES
Last Name:REINERT
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 S GOVERNORS AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3530
Mailing Address - Country:US
Mailing Address - Phone:302-730-4366
Mailing Address - Fax:
Practice Address - Street 1:540 S GOVERNORS AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3530
Practice Address - Country:US
Practice Address - Phone:302-730-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000929363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical