Provider Demographics
NPI:1366426777
Name:REH, RICHARD C (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:REH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2480 LLEWELLYN AVE
Mailing Address - Street 2:ATTN: MCXR-CR KIMBROUGH AMBULATORY CARE CENTER
Mailing Address - City:FT. MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755
Mailing Address - Country:US
Mailing Address - Phone:301-677-8270
Mailing Address - Fax:301-677-8176
Practice Address - Street 1:2480 LLEWELLYN AVE.
Practice Address - Street 2:ATTN: MCXR-CR KIMBROUGH AMBULATORY CARE CENTER
Practice Address - City:FT. MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755
Practice Address - Country:US
Practice Address - Phone:301-677-8270
Practice Address - Fax:301-677-8176
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD024472-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33484Medicare UPIN