Provider Demographics
NPI:1215254339
Name:REICHENBACH, BERNICE C (MD)
Entity type:Individual
Prefix:DR
First Name:BERNICE
Middle Name:C
Last Name:REICHENBACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2605 KINARD ST STE 208
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-2966
Mailing Address - Country:US
Mailing Address - Phone:803-945-4202
Mailing Address - Fax:803-945-4238
Practice Address - Street 1:2605 KINARD ST STE 208
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-2966
Practice Address - Country:US
Practice Address - Phone:803-945-4202
Practice Address - Fax:803-945-4238
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC95220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009369700Medicaid
FL009369700Medicaid