Individual
RENATO F DELACRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 E MAIN ST STE D, SAINT CLAIRSVILLE, OH 43950-1583
(740) 296-5702
(740) 296-5705
Mailing address
PO BOX 6230, WHEELING, WV 26003-0722
(304) 242-7106
(304) 242-7106
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35060832
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0079563000
—
WV
05
—
0822533
—
OH
01
—
110248353
RR MEDICARE
—
01
—
DG5378
GROUP RR MEDICARE
OH
Enumeration date
07/27/2005
Last updated
04/26/2021
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