Individual
RENEE C MOENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1110 W MICHIGAN ST, ROOM #545, INDIANAPOLIS, IN 46202-5209
(317) 274-7724
(317) 274-7792
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01062129A
IN
207R00000X
Internal Medicine Physician
20030447
NM
207RR0500X
Rheumatology Physician
Primary
01062129A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200906220
—
IN
05
—
76335283
—
NM
Enumeration date
10/03/2006
Last updated
01/18/2021
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