Individual
MICAH DAVID RENICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
209 W EVERGREEN AVE, PALMER, AK 99645-6952
(907) 861-1450
Mailing address
209 W EVERGREEN AVE STE A, PALMER, AK 99645-6952
(907) 861-1450
(833) 906-2375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
228046
AK
Other
Enumeration date
03/22/2021
Last updated
10/01/2024
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