Individual
RENEE RAIMONDI DEWEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
SUMMIT CROSSING PLACE, STE 106, GASTONIA, NC 28054
(704) 867-8021
(704) 864-4606
Mailing address
620 SUMMIT CROSSING PL, STE 106, GASTONIA, NC 28054-2176
(704) 867-8021
(704) 864-4606
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
200000394
NC
2085R0202X
Diagnostic Radiology Physician
200000394
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126JU
BLUE CROSS BLUE SHIELD
—
01
—
1643188
UNITED HEALTHCARE
—
01
—
2353072
AETNA HMO
—
01
—
300110411
RAILROAD MEDICARE
—
01
—
37295
PARTNERS
—
01
—
7543124
AETNA PPO
—
05
—
89126JU
—
NC
01
—
97384
MEDCOST
—
Enumeration date
01/04/2006
Last updated
03/14/2012
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