Provider Demographics
NPI:1952375289
Name:REICH, SCOTT BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BRADLEY
Last Name:REICH
Suffix:
Gender:M
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:WPSC-SVA BILLING
Mailing Address - Street 2:P.O. BOX 44159
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53744
Mailing Address - Country:US
Mailing Address - Phone:608-826-2663
Mailing Address - Fax:
Practice Address - Street 1:WISCONSIN PATHOLOGISTS, S.C.
Practice Address - Street 2:36 S. BROOKS ST.
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715
Practice Address - Country:US
Practice Address - Phone:608-267-6267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI28057207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology