Reynolds, Michael B
Reynolds, Michael B is an individual health care provider with primary practice located at 605 S Enota Dr Ne , Gainesville GA 30501-2437. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Reynolds, Michael B can be contacted via phone (770) 538-0208.Contact Information
Primary practice address
605 S Enota Dr Ne
Gainesville GA 30501-2437
Phone: (770) 538-0208
Fax: (770) 538-0556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 046224 | Georgia |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 046224 | Georgia |
Profile Details
| NPI number | 1487604021 |
|---|---|
| LBN Legal business name | Reynolds, Michael B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Sep 30th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487604021 | NPPES |
| Georgia | Other | 1487604021 | BCBS |
| Georgia | Other | CH9982 | BCBS |
| Georgia | Other | 0007735230 | BCBS |
| Georgia | Other | 070015990 | BCBS |
| Georgia | MEDICAID | 000814767A | BCBS |
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