Individual
RANDOLPH H RENZI
Active
Individual
RANDOLPH H RENZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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