| Doctor Name: | KEITH C REINWALD |
| NPI Number: | 1033278049 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 582 |
| Business Practice Address: | 2376 Cypress Cir Ste 300 Conway, SC - 295268995 |
| Business Phone Number: | 8433477222 |
| Business Fax Number: | 8433473305 |
| Mailing Address: | 2376 Cypress Cir Ste 300, CONWAY |
| State: | SC |
| Postal Code: | 295268995 |
| Phone Number: | 8433477222 |
| Fax Number: | 8433473305 |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 04/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |