Provider Demographics
NPI:1023086303
Name:REID, HOLLIS C (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLIS
Middle Name:C
Last Name:REID
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 1:5009 HONEYGO CENTER DR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9815
Mailing Address - Country:US
Mailing Address - Phone:410-256-5858
Mailing Address - Fax:410-529-2431
Practice Address - Street 1:5009 HONEYGO CENTER DR
Practice Address - Street 2:SUITE 216
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9815
Practice Address - Country:US
Practice Address - Phone:410-256-5858
Practice Address - Fax:410-529-2431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD57060207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD089L 216LMedicare ID - Type Unspecified
C09156Medicare UPIN