Provider Demographics
NPI:1255514162
Name:MICHELLE L REAMES O.D.,P.A.
Entity type:Organization
Organization Name:MICHELLE L REAMES O.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:REAMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD, PA
Authorized Official - Phone:828-254-3230
Mailing Address - Street 1:508 MERRIMON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-6624
Mailing Address - Country:US
Mailing Address - Phone:828-254-3230
Mailing Address - Fax:828-258-2232
Practice Address - Street 1:508 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-6624
Practice Address - Country:US
Practice Address - Phone:828-254-3230
Practice Address - Fax:828-258-2232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHELLE L REAMES O.D.,P. A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-13
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC1987152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08918055 NCMedicaid