RENAISSANCE MEDICAL CENTER PLLC (NPI# 1205148616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205148616 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE MEDICAL CENTER PLLC |
| Practice Address |
430 Mack Ave Detroit MI 48201-2136 |
| Practice Telephone | 3138315913 |
| Practice Fax Number | 3138315991 |
| Mailing Telephone | 3138315913 |
| Mailing Fax Number | 3138315991 |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2010-07-14 |
| Authorized Official Name | DIMPLE TRIPATHI (MEMBER) |
| Authorized Official Telephone | 3138315913 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | Other Service Providers |
| Street Address |
430 MACK AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801863998 | Medical Management PC | Family Medicine | 430 Mack Ave, Detroit, MI 48201-2136 | 2006-03-07 |
| 1104482439 | Childrens Dental Care of Detroit | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2019-05-13 |
| 1104376771 | Darnell Kaigler Pllc | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2016-10-07 |
| 1821542010 | Arianne Sophia Swanson | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2016-08-05 |
| 1235437807 | Rio Detroit Inc | Pharmacy | 430 Mack Ave, Detroit, MI 48201-2136 | 2011-03-07 |
| 1588971980 | Mack Medical Management LLC | Specialist | 430 Mack Ave, Detroit, MI 48201-2136 | 2010-09-07 |
| 1861668089 | Anant Inc | Pharmacy | 430 Mack Ave, Detroit, MI 48201-2136 | 2008-05-07 |
| 1295908069 | Dmxrx Ltd | Pharmacy | 430 Mack Ave, Detroit, MI 48201-2136 | 2008-04-11 |
| 1205008125 | Ruben Taguiam Benito | Legal Medicine | 430 Mack Ave, Suite B, Detroit, MI 48201 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 170100000X |
| Grouping | Other Service Providers |
| Classification | Medical Genetics, Ph.D. Medical Genetics |
| A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
| Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518279058 | Susan Michalowski | Medical Genetics, Ph.D. Medical Genetics | 440 Burroughs St Ste 446, Detroit, MI 48202-3429 | 2010-07-13 |
| 1689885535 | Deon D Middlebrook M D PC | Medical Genetics, Ph.D. Medical Genetics | 20176 Livernois Ave, Detroit, MI 48221-1346 | 2007-05-24 |
| 1871672964 | Sandra L Nehlsen-cannarella | Medical Genetics, Ph.D. Medical Genetics | 3990 John R St, G518, Detroit, MI 48201-2018 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912412792 | Kirit Pindolia | Medical Genetics, Ph.D. Medical Genetics | 48142 Royal Pointe Dr, Canton, MI 48187-5466 | 2017-12-03 |
| 1134377450 | Nemer Ebeid Hanna | Medical Genetics, Ph.D. Medical Genetics | 7214 Danbrooke, West Bloomfield, MI 48322-2927 | 2008-08-28 |
| 1750304796 | Mark William Thomas | Medical Genetics, Ph.D. Medical Genetics | 7210 N Main St Ste 205, Clarkston, MI 48346-1575 | 2006-07-25 |
| 1760487540 | Helga Valdmanis Toriello | Medical Genetics, Ph.D. Medical Genetics | 21 Michigan St Ne, Ste 465, Grand Rapids, MI 49503-2530 | 2005-06-17 |
| 1225406820 | Enas Eraqi | Medical Genetics, Ph.D. Medical Genetics | 33155 Annapolis St, Wayne, MI 48184-2405 | 2015-09-13 |
| 1376728857 | Oak Neurovascular P.C. | Medical Genetics, Ph.D. Medical Genetics | 24361 Greenfield Rd, Suite 202, Southfield, MI 48075-3139 | 2008-01-03 |
| 1922288703 | Pramod Raval M.d P.C. | Medical Genetics, Ph.D. Medical Genetics | 3120 Carpenter St, Suite 313, Hamtramck, MI 48212-9802 | 2007-11-08 |
| 1760699979 | Rita D Rogers | Medical Genetics, Ph.D. Medical Genetics | 1009 Drexel St, Dearborn, MI 48128-1639 | 2007-05-17 |
| 1023223476 | Ronald Rice | Medical Genetics, Ph.D. Medical Genetics | 32910 W 13 Mile Rd, D-402, Farmington Hills, MI 48334-1980 | 2007-05-11 |
| 1801914510 | Ramaswamy Krishna Iyer | Medical Genetics, Ph.D. Medical Genetics | 1150 W Medical Center Dr, 3725a Medical Sciences Building II, Box 0629, Ann Arbor, MI 48109-0799 | 2007-03-27 |
| Find all providers with the same taxonomy | ||||
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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.