Provider Demographics
NPI:1962506436
Name:REESE, VICKI ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:ELAINE
Last Name:REESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12146 SWEET CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1866
Mailing Address - Country:US
Mailing Address - Phone:301-595-0379
Mailing Address - Fax:
Practice Address - Street 1:12146 SWEET CLOVER DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1866
Practice Address - Country:US
Practice Address - Phone:301-595-0379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD438302086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery