Provider Demographics
NPI:1144326810
Name:REIDER, MITCHELL W (MD)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:W
Last Name:REIDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3909 ORANGE PL
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4478
Mailing Address - Country:US
Mailing Address - Phone:216-896-1778
Mailing Address - Fax:216-896-1780
Practice Address - Street 1:3909 ORANGE PL
Practice Address - Street 2:SUITE 2500
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4478
Practice Address - Country:US
Practice Address - Phone:216-896-1778
Practice Address - Fax:216-896-1780
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-02-19
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Provider Licenses
StateLicense IDTaxonomies
OH35076274R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H35078Medicare UPIN