Provider Demographics
NPI:1871584755
Name:REINHARDT, LIGEIA A (MD)
Entity type:Individual
Prefix:DR
First Name:LIGEIA
Middle Name:A
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:116 NOBLE LN
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-5104
Mailing Address - Country:US
Mailing Address - Phone:208-267-3707
Mailing Address - Fax:208-267-3707
Practice Address - Street 1:6615 COMANCHE ST
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-7523
Practice Address - Country:US
Practice Address - Phone:208-267-1718
Practice Address - Fax:208-267-7739
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM8667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806590100Medicaid
I24897Medicare UPIN
ID806590100Medicaid
ID13-1822Medicare Oscar/Certification