Provider Demographics
NPI:1477608198
Name:DAVID S. REID, IV MD PA
Entity type:Organization
Organization Name:DAVID S. REID, IV MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MITZE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SEGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-886-1667
Mailing Address - Street 1:1011 N LINDSAY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3944
Mailing Address - Country:US
Mailing Address - Phone:336-886-1667
Mailing Address - Fax:336-886-5536
Practice Address - Street 1:1011 N LINDSAY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3944
Practice Address - Country:US
Practice Address - Phone:336-886-1667
Practice Address - Fax:336-886-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94013122086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8971096Medicaid
NCE43670Medicare UPIN
NC2211514Medicare ID - Type Unspecified