Provider Demographics
NPI:1750611570
Name:JOSEPH A REINHARDT MD PA
Entity type:Organization
Organization Name:JOSEPH A REINHARDT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-879-4590
Mailing Address - Street 1:2003 ROCK SPRING RD
Mailing Address - Street 2:#7
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2611
Mailing Address - Country:US
Mailing Address - Phone:410-879-4590
Mailing Address - Fax:410-420-1602
Practice Address - Street 1:2003 ROCK SPRING RD
Practice Address - Street 2:#7
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2611
Practice Address - Country:US
Practice Address - Phone:410-879-4590
Practice Address - Fax:410-420-1602
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPH A REINHARDT MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015673174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7011JAOtherBLUE CROSS BLUE SHIELD
MD18837 1200Medicaid
MDR3850001OtherBLUE CROSS BLUE SHIELD FEDERAL
MD=========OtherTRICARE
MD18837 1200Medicaid
MDR3850001OtherBLUE CROSS BLUE SHIELD FEDERAL