| Michael David Reavis Jr, MS, RD, LDN | |
|
8388 Court Ave, Ellicott City, MD 21043-5200 | |
| (240) 646-6768 | |
| Not Available |
| Full Name | Michael David Reavis Jr |
|---|---|
| Gender | Male |
| Speciality | Dietitian, Registered - Nutrition, Sports Dietetics |
| Location | 8388 Court Ave, Ellicott City, Maryland |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245906585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1501X | Dietitian, Registered - Nutrition, Sports Dietetics | DX5056 (Maryland) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Michael David Reavis Jr, MS, RD, LDN 8306 Satinleaf Ct, Bowie, MD 20715-4575 Ph: (240) 646-6768 | Michael David Reavis Jr, MS, RD, LDN 8388 Court Ave, Ellicott City, MD 21043-5200 Ph: (240) 646-6768 |
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