Provider Demographics
NPI:1952366338
Name:REED, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9555 UPLAND LN N FL 3
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4485
Mailing Address - Country:US
Mailing Address - Phone:952-993-1440
Mailing Address - Fax:952-977-3172
Practice Address - Street 1:9555 UPLAND LN N FL 3
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4485
Practice Address - Country:US
Practice Address - Phone:952-993-1440
Practice Address - Fax:952-977-3172
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN53740208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD420301100Medicaid
MD420301100Medicaid
MD850EMedicare ID - Type Unspecified