Provider Demographics
NPI:1952931628
Name:REED, RICHARD DAMON
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DAMON
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 RIVERWOOD PKWY SE STE 1953
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6401
Mailing Address - Country:US
Mailing Address - Phone:770-628-7155
Mailing Address - Fax:678-383-4937
Practice Address - Street 1:3350 RIVERWOOD PKWY SE STE 1953
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6401
Practice Address - Country:US
Practice Address - Phone:770-628-7155
Practice Address - Fax:678-383-4937
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies