Individual
RANDOLPH H RENZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1880 AMHERST STREET, SUITE 100 AND SUITE 200, WINCHESTER, VA 22601-2872
(540) 662-0306
(855) 264-2066
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(540) 662-0306
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
0101045302
VA
207RI0011X
Interventional Cardiology Physician
18128
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000674642
MOUNTAIN STATE BCBS
WV
05
—
006036155
—
VA
05
—
0085714000
—
WV
01
—
068565
ANTHEM BCBS
VA
05
—
091241700
—
MD
01
—
16284
OPTIMA HEALTH SENTARA
VA
01
—
2119598
MAMSI
VA
01
—
502807
NCPPO
VA
01
—
9318661
MEDICARE GROUP
WV
01
—
C00075
MEDICARE GROUP
VA
Enumeration date
01/13/2006
Last updated
12/07/2022
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