DR. OWEN DAVID REYNOLDS (NPI# 1407845712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407845712 |
| Entity Type | Individual |
| Full Name | DR. OWEN DAVID REYNOLDS |
| Credential | M.D. |
| Practice Address |
198 Massachusetts Ave Ste 105 North Andover MA 01845-4143 |
| Mailing Address |
280 Merrimack St Ste 311 Lawrence MA 01843-1779 |
| Practice Telephone | 9786915690 |
| Practice Fax Number | 9786915693 |
| Mailing Telephone | 9786915690 |
| Mailing Fax Number | 9786915693 |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2018-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 74177 | MA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
74177 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 3102769 | 05 |
| Street Address |
198 MASSACHUSETTS AVE STE 105 |
| City | NORTH ANDOVER |
| State | MA |
| Zip Code | 01845-4143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801885918 | Mary D Gibney | Dermatology | 198 Massachusetts Ave Ste 105, North Andover, MA 01845-4143 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780222091 | Bh Brightview North Andover Opco, LLC | Alzheimer Center (Dementia Center) | 1275 Turnpike Street, North Andover, MA 01845 | 2019-12-17 |
| 1770132052 | Nancy Boshar | Social Worker | 109 Saw Mill Road, North Andover, MA 01845 | 2019-09-09 |
| 1497307854 | Maria Nappa | Nurse Practitioner | 47 High Street, Suite 101, North Andover, MA 01845 | 2019-07-15 |
| 1235794041 | North Andover Women's Care Pllc | Obstetrics & Gynecology | 100 Andover Bypass, Suite 300, North Andover, MA 01845 | 2019-05-07 |
| 1891278040 | Kristen Dee | Counselor | 6 Garnet Circle, North Andover, MA 01845 | 2018-09-13 |
| 1154809770 | Oped Medical, Inc. | Durable Medical Equipment & Medical Supplies | 37 Flagship Drive, North Andover, MA 01845 | 2018-08-06 |
| 1902382658 | Barry Myers | Physical Therapist | 231 Sutton Street, Suite 1c, North Andover, MA 01845 | 2018-07-16 |
| 1174042337 | Beth Israel Lahey Health Primary Care, Inc. | Internal Medicine | Lahey Health Primary Care, North Andover, 170 Pleasant St., N. Andover, MA 01845 | 2017-09-19 |
| 1174041792 | Eric Tweedie | Specialist/Technologist | 72 Fernview Ave Apt 2, North Andover, MA 01845 | 2017-09-04 |
| 1043734379 | Hiron Health | Internal Medicine | 820a Turnpike Street, North Andover, MA 01845 | 2017-07-28 |
| Find all providers in zip 01845 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578761482 | Megan L Bernstein | Dermatology | 401 Andover Street, Suite 101, Northeast Dermatology Associates, North Andover, MA 01845 | 2007-07-03 |
| 1538264098 | Jeremy P Finkle | Dermatology | 538 Turnpike St, North Andover, MA 01845-5812 | 2006-09-13 |
| 1043683923 | Nedas LLC | Dermatology | 401 Andover St, Suite 101, North Andover, MA 01845-5076 | 2015-11-02 |
| 1669844163 | Nedan Pllc | Dermatology | 538 Turnpike St, North Andover, MA 01845-5812 | 2015-10-22 |
| 1407198690 | Skylar Amanda Souyoul | Dermatology | 538 Turnpike St, North Andover, MA 01845-5812 | 2013-03-26 |
| 1891007035 | Stephanie Aamodt St Pierre | Dermatology | 538 Turnpike St, North Andover, MA 01845-5812 | 2010-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669090445 | Peter T Demos Md | Dermatology | 125 Liberty St Ste 206, Springfield, MA 01103-1109 | 2020-07-08 |
| 1376180760 | Integrated Dermatology of Needham, LLC | Dermatology | 60 Dedham Ave Ste 206, Needham, MA 02492-3061 | 2019-12-04 |
| 1164069647 | Integrated Dermatology of Mashton, LLC | Dermatology | 800 Falmouth Rd Ste 101, Mashpee, MA 02649-3303 | 2019-12-04 |
| 1972164937 | Kuchnir Realty, LLC | Dermatology | 11 Apex Dr Ste 103a, Marlborough, MA 01752-1860 | 2019-06-21 |
| 1265098032 | Mark Amster Derm | Dermatology | 800 Falmouth Rd Ste 101b, Mashpee, MA 02649-3352 | 2019-05-16 |
| 1831684224 | Chotinij Lertphanichkul | Dermatology | 850 Boylston St Ste 437, Chestnut Hill, MA 02467-2405 | 2018-06-27 |
| 1023515277 | Vibrant Dermatology Pllc | Dermatology | 588 Providence Hwy, Dedham, MA 02026-6804 | 2018-04-12 |
| 1437665908 | Kuchnir Dermatology, PC | Dermatology | 20 Hope Ave Ste 105, Waltham, MA 02453-2717 | 2017-12-20 |
| 1265941082 | Integrated Dermatology Group, LLC | Dermatology | 280 Washington St Ste 212, Brighton, MA 02135-3511 | 2017-09-25 |
| 1679098750 | Avant-garde Medical LLC | Dermatology | 62 Pleasant St, Natick, MA 01760-5634 | 2017-08-09 |
| Find all providers with the same taxonomy | ||||
| City | NORTH ANDOVER |
| Zip Code | 01845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.