Provider Demographics
NPI:1285617399
Name:PARLIER, REGGIE D (MD)
Entity type:Individual
Prefix:
First Name:REGGIE
Middle Name:D
Last Name:PARLIER
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:PO BOX 551028
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28055-1028
Mailing Address - Country:US
Mailing Address - Phone:704-853-3314
Mailing Address - Fax:704-853-7922
Practice Address - Street 1:2544 COURT DR
Practice Address - Street 2:SUITE D
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3450
Practice Address - Country:US
Practice Address - Phone:704-853-3314
Practice Address - Fax:704-853-7922
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89012YNMedicaid
E48484Medicare UPIN
NC2195298AMedicare ID - Type Unspecified