Organization
RENAISSANCE PRIMARY CARE AND WELLNESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDIWE F GREENWOOD MD (OWNER PHYSICIAN)
(410) 772-8001
Entity
Organization
Contact information
Practice address
5500 KNOLL NORTH DR, SUITE 250, COLUMBIA, MD 21045-2209
(410) 772-8001
(410) 772-8004
Mailing address
5500 KNOLL NORTH DR, SUITE 250, COLUMBIA, MD 21045-2209
(410) 772-8001
(410) 772-8004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0060109
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33760001
BLUE CHOICE
MD
05
—
405788100
—
MD
01
—
75XBLF
MD BLUE SHIELD
MD
Enumeration date
05/01/2007
Last updated
05/13/2008
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