Reister, Randolph J

Reister, Randolph J is an individual health care provider with primary practice located at 710 Division St S , Northfield MN 55057-2468. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Reister, Randolph J can be contacted via phone (507) 646-1494.

Contact Information

Primary practice address
710 Division St S Northfield MN 55057-2468
Phone: (507) 646-1494
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 5242 South Dakota
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 102423 Minnesota

Profile Details

NPI number 1952385114
LBN Legal business name Reister, Randolph J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Mar 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952385114 NPPES
South Dakota MEDICAID 6004640

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