Provider Demographics
NPI:1184894131
Name:JOHN FRED REINHARDT, MD PA
Entity type:Organization
Organization Name:JOHN FRED REINHARDT, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-731-0800
Mailing Address - Street 1:4745 OGLETOWN-STANTON ROAD
Mailing Address - Street 2:MEDICAL ARTS PAVILION ONE #138
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-731-0800
Mailing Address - Fax:302-731-7888
Practice Address - Street 1:4745 OGLETOWN-STANTON ROAD
Practice Address - Street 2:MEDICAL ARTS PAVILION ONE #138
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-731-0800
Practice Address - Fax:302-731-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0002659207R00000X, 207RI0200X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE801160Medicare PIN
DE6223270001Medicare NSC