Individual
SAMUEL RENIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
155 RADIO DR, WOODBURY, MN 55125-2619
(952) 831-8742
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DR.0070456
CO
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
69921
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2020
Last updated
09/09/2024
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