Provider Demographics
NPI:1487742235
Name:REID, H. STANLEY (MD)
Entity type:Individual
Prefix:DR
First Name:H. STANLEY
Middle Name:
Last Name:REID
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 1:209 PATEWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3589
Mailing Address - Country:US
Mailing Address - Phone:864-234-9900
Mailing Address - Fax:864-234-9090
Practice Address - Street 1:209 PATEWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3589
Practice Address - Country:US
Practice Address - Phone:864-234-9900
Practice Address - Fax:864-234-9090
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12183207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC121834Medicaid
SCA99061Medicare UPIN