| Michael T. Rendler, Pc | |
|
401 Michigan St Pueblo CO 81004-2138 | |
| (719) 545-3555 | |
| (719) 545-1517 |
| Full Name | Michael T. Rendler, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Michigan St, Pueblo, Colorado |
| Authorized Official Name and Position | Michael T Rendler (OWNER) |
| Authorized Official Contact | 7195453555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael T. Rendler, Pc 401 Michigan St Pueblo CO 81004-2138 Ph: (719) 545-3555 | Michael T. Rendler, Pc 401 Michigan St Pueblo CO 81004-2138 Ph: (719) 545-3555 |
| NPI Number | 1528384161 |
|---|---|
| Provider Enumeration Date | 04/07/2010 |
| Last Update Date | 08/19/2010 |
| Medicare PECOS PAC ID | 4981728896 |
|---|---|
| Medicare Enrollment ID | O20100830000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528384161 | NPI | - | NPPES |
| 71871853 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael T Rendler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386623403 PECOS PAC ID: 1153445069 Enrollment ID: I20100830000763 |
| Provider Name | Carlotta J Fendrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427015767 PECOS PAC ID: 7719994094 Enrollment ID: I20150918002497 |
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