Basic Information
| Provider Information | |||||||||
| NPI: | 1760479588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REID | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 W MAIN CROSS ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458402423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194241393 | ||||||||
| FaxNumber: | 4194243424 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 W MAIN CROSS ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458402423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194241393 | ||||||||
| FaxNumber: | 4194243424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 12/08/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 35070529 | OH | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 0270308 | 05 | OH | MEDICAID | 000000130137 | 01 | OH | BLUE CROSS BLUE SHIELD NO | OTHER |