Provider Demographics
NPI:1255431441
Name:REINBOLD, PAUL MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MATTHEW
Last Name:REINBOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5445 TATES BANK RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-3422
Mailing Address - Country:US
Mailing Address - Phone:410-430-2202
Mailing Address - Fax:410-820-4997
Practice Address - Street 1:321 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:FEDERALSBURG
Practice Address - State:MD
Practice Address - Zip Code:21632-1727
Practice Address - Country:US
Practice Address - Phone:410-754-5505
Practice Address - Fax:410-754-5544
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD144000400Medicaid
MD250M334FMedicare PIN
G00880Medicare UPIN