Individual
ANN M RENUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 E PARIS AVE SE, SUITE 130, GRAND RAPIDS, MI 49546-3680
(616) 949-2001
(616) 949-8620
Mailing address
1000 E PARIS AVE SE, SUITE 130, GRAND RAPIDS, MI 49546-3680
(616) 949-2001
(616) 949-8620
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301079485
MI
207W00000X
Ophthalmology Physician
Primary
4301079485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104457907
—
MI
Enumeration date
02/10/2006
Last updated
04/12/2017
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