Individual
GARY T RENALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(336) 277-2000
(336) 277-2050
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(366) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
33559
NC
207RI0011X
Interventional Cardiology Physician
33559
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285682310
WSCA GRP NPI #
NC
05
—
1932168663
—
VA
01
—
71244
BCBS ID#
NC
01
—
757
PARTNERS ID#
NC
05
—
8971244
—
NC
Enumeration date
03/21/2006
Last updated
03/07/2023
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