Reynolds, Owen David
Reynolds, Owen David is an individual health care provider with primary practice located at 198 Massachusetts Ave Ste 105 , North Andover MA 01845-4143. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Reynolds, Owen David can be contacted via phone (978) 691-5690.Contact Information
Primary practice address
198 Massachusetts Ave Ste 105
North Andover MA 01845-4143
Phone: (978) 691-5690
Fax: (978) 691-5693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 74177 | Massachusetts |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 74177 | Massachusetts |
Profile Details
| NPI number | 1407845712 |
|---|---|
| LBN Legal business name | Reynolds, Owen David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2005 |
| Last updated | Dec 3rd, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407845712 | NPPES |
| Massachusetts | MEDICAID | 3102769 |
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