Individual
MICHAEL A TRENAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TL 124
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310763
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/20/2006
Last updated
07/08/2007
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