Provider Demographics
NPI:1306810429
Name:REIN, MITCHELL S (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:REIN
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 1:81 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2714
Mailing Address - Country:US
Mailing Address - Phone:978-744-7668
Mailing Address - Fax:
Practice Address - Street 1:1 HUTCHINSON DR
Practice Address - Street 2:NSMC-WOMEN'S CENTER
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3759
Practice Address - Country:US
Practice Address - Phone:978-739-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56895207VE0102X
MI56895207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000178OtherMASSHEALTH NHP
MA3020631Medicaid
MA5237OtherHPHC
MAB20457501OtherCIGNA
MAH06371OtherBCBS
MAREIN-731205OtherTUFTS HEALTH PLAN
MA865122OtherAETNA/US
MA74813Medicare UPIN
MAB20457501OtherCIGNA