Provider Demographics
NPI:1700150422
Name:DAVID W. REID, M.D., P.C.
Entity type:Organization
Organization Name:DAVID W. REID, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-456-0505
Mailing Address - Street 1:1060 LASKIN RD
Mailing Address - Street 2:UNIT 11B
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6365
Mailing Address - Country:US
Mailing Address - Phone:757-456-0505
Mailing Address - Fax:757-456-0817
Practice Address - Street 1:1060 LASKIN RD
Practice Address - Street 2:UNIT 11B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6365
Practice Address - Country:US
Practice Address - Phone:757-456-0505
Practice Address - Fax:757-456-0817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040004931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty