Provider Demographics
NPI:1831180454
Name:REICHL, CHRISTINE M (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:REICHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31932207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110913OtherU-CARE
986025OtherPREFERRED ONE
HP22735OtherHEALTH PARTNERS
6D083REOtherBLUE CROSS BLUE SHIELD
600876OtherARAZ GRP/AMERICA'S PPO
0427389OtherMEDICA HEALTH PLANS
2114150OtherFIRST HEALTH PLAN
942398200OtherMEDICAL ASSISTANCE
942398200OtherMEDICAL ASSISTANCE
119001627Medicare ID - Type Unspecified