Provider Demographics
NPI:1215641816
Name:REESE, MAJID IBNAMIN I
Entity type:Individual
Prefix:
First Name:MAJID
Middle Name:IBNAMIN
Last Name:REESE
Suffix:I
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 1:511 REV HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27537-6909
Mailing Address - Country:US
Mailing Address - Phone:252-820-3752
Mailing Address - Fax:
Practice Address - Street 1:511 REV HENDERSON RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-6909
Practice Address - Country:US
Practice Address - Phone:252-820-3752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21157030347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle