Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL DAVID REAVIS JR., MS, RD, LDN
ActiveSports Dietetics · ELLICOTT CITY, MD
Registration Details
- NPI Number
- 1245906585
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 17, 2021 (4.6802788020556 yrs)
- Last Updated
- Aug 17, 2021
- License
-
DX5056 (MD)
Practice Information
- Address
-
8388 COURT AVEELLICOTT CITY, MD, 210435200Browse MD providers · Browse ZIP 21043
- Phone
- 2406466768
- Primary Specialty
-
Sports Dietetics
133VN1501X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.