Provider Demographics
NPI:1841255528
Name:REITER, BEN Z (MD)
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:Z
Last Name:REITER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:304 INDIAN TRCE
Mailing Address - Street 2:534
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2996
Mailing Address - Country:US
Mailing Address - Phone:954-474-7422
Mailing Address - Fax:954-474-9883
Practice Address - Street 1:3303 SW BOND AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-494-8573
Practice Address - Fax:503-494-3457
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2014-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD164852207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93794VMedicare ID - Type Unspecified
DCD63008Medicare UPIN