| Renaissance Family Medicine, Llc | |
|
2580 Charlestown Rd Suite 2 New Albany IN 47150 | |
| (812) 948-9500 | |
| (812) 948-9600 |
| Full Name | Renaissance Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2580 Charlestown Rd, New Albany, Indiana |
| Authorized Official Name and Position | Anna M. Fisher (MANAGER/OWNER) |
| Authorized Official Contact | 8129489500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Family Medicine, Llc 2580 Charlestown Rd Suite 2 New Albany IN 47150 Ph: (812) 948-9500 | Renaissance Family Medicine, Llc 2580 Charlestown Rd Suite 2 New Albany IN 47150 Ph: (812) 948-9500 |
| NPI Number | 1720287071 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 12/28/2018 |
| Medicare PECOS PAC ID | 6305096751 |
|---|---|
| Medicare Enrollment ID | O20121022000398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720287071 | NPI | - | NPPES |
| 100116610A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01036882A (Indiana) | Primary |
| Provider Name | Anna Marie Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972591915 PECOS PAC ID: 9133141278 Enrollment ID: I20060103000705 |
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