Provider Demographics
NPI:1548278146
Name:REINHARDT, JOHN FRED (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRED
Last Name:REINHARDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4745 OGLETOWN STANTON RD
Mailing Address - Street 2:MEDICAL ARTS PAVILION ONE #138
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2067
Mailing Address - Country:US
Mailing Address - Phone:302-731-0800
Mailing Address - Fax:302-731-7888
Practice Address - Street 1:4745 OGLETOWN STANTON RD
Practice Address - Street 2:MEDICAL ARTS PAVILION ONE #138
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2067
Practice Address - Country:US
Practice Address - Phone:302-731-0800
Practice Address - Fax:302-731-7888
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2015-03-24
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Provider Licenses
StateLicense IDTaxonomies
DEC10002659207R00000X
DEC1-0002659207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000331602Medicaid
PA01274449Medicaid
DE110013026OtherRR MEDICARE
MD295471100Medicaid
NJ6764100Medicaid
DE0000331602Medicaid
DE130729J60Medicare PIN