Individual
DR. MAXWELL EDWARD RENNAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2700 5 MILE RD NE STE 102, GRAND RAPIDS, MI 49525-6516
(330) 908-8000
Mailing address
3736 PRAIRIE ST SW, GRANDVILLE, MI 49418-1634
(616) 648-8456
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005238
MI
152W00000X
Optometrist
OPT.006660
OH
Other
Enumeration date
05/31/2018
Last updated
09/09/2020
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