| Renaissance Primary Care And Wellness Group Llc | |
|
5500 Knoll North Dr Suite 250 Columbia MD 21045-2209 | |
| (410) 772-8001 | |
| (410) 772-8004 |
| Full Name | Renaissance Primary Care And Wellness Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5500 Knoll North Dr, Columbia, Maryland |
| Authorized Official Name and Position | Lindiwe F Greenwood (OWNER PHYSICIAN) |
| Authorized Official Contact | 4107728001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Primary Care And Wellness Group Llc 5500 Knoll North Dr Suite 250 Columbia MD 21045-2209 Ph: (410) 772-8001 | Renaissance Primary Care And Wellness Group Llc 5500 Knoll North Dr Suite 250 Columbia MD 21045-2209 Ph: (410) 772-8001 |
| NPI Number | 1609097112 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609097112 | NPI | - | NPPES |
| 405788100 | Medicaid | MD | |
| 75XBLF | Other | MD | MD BLUE SHIELD |
| 33760001 | Other | MD | BLUE CHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0060109 (Maryland) | Primary |
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