Individual
RENAISA ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2601 TVC, NASHVILLE, TN 37232-0001
(615) 322-4916
Mailing address
PO BOX 2076, SAN JOSE, CA 95109-2076
(402) 350-1141
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
C151484
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/04/2007
Last updated
05/28/2020
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