Individual
MARC B RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
705 N 5TH AVE, ANN ARBOR, MI 48104-1006
(734) 645-6206
Mailing address
705 N 5TH AVE, ANN ARBOR, MI 48104-1006
(734) 645-6206
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301406728
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2642906
—
MI
01
—
300020174
RAILROAD MEDICARE
—
01
—
3103898601
BCBS OF MICHIGAN
MI
Enumeration date
08/09/2005
Last updated
11/05/2015
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