Provider Demographics
NPI:1699976662
Name:REINIGHAUS, CARL H (DO)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:H
Last Name:REINIGHAUS
Suffix:
Gender:M
Credentials:DO
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 473
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-0473
Mailing Address - Country:US
Mailing Address - Phone:906-774-5082
Mailing Address - Fax:
Practice Address - Street 1:135 SOUTH BASS LAKE LANE
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-0473
Practice Address - Country:US
Practice Address - Phone:906-774-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006227207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine