Doctor Name: | MR. ROBIN RUSSELL REYE |
NPI Number: | 1427092410 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SAPA-C |
License Number: | 5601001893 |
Business Practice Address: | 4228 Mt. Morris Rd Columbiaville, MI - 48421 |
Business Phone Number: | 8107932241 |
Business Fax Number: | 8107932587 |
Mailing Address: | 4228 Mount Morris Rd, COLUMBIAVILLE |
State: | MI |
Postal Code: | 484219373 |
Phone Number: | 8107932241 |
Fax Number: | 8107932587 |
NPI Enumeration Date: | 06/16/2006 |
NPI Last Update Date: | 05/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5601001893 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |