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RENAISSANCE PRIMARY CARE AND WELLNESS GROUP LLC NPI 1609097112


NPI Information

NPI: 1609097112
Provider Name: RENAISSANCE PRIMARY CARE AND WELLNESS GROUP LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
5500 KNOLL NORTH DR
SUITE 250
COLUMBIA, MD
ZIP 21045
Phone: (410) 772-8001
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RENAISSANCE PRIMARY CARE AND WELLNESS GROUP LLC is a family medicine in Columbia, MD. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RENAISSANCE PRIMARY CARE AND WELLNESS GROUP LLC NPI is 1609097112. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5500 KNOLL NORTH DR
SUITE 250
COLUMBIA, MD
ZIP 21045-209
Phone: (410) 772-8001
Fax: (410) 772-8004

The provider's authorized official is Lindiwe F Greenwood .
The authorized official title is Owner Physician and has the following contact phone number (410) 772-8001.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 5/13/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineD0060109MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
175XBLFOTHERMARYLANDMD BLUE SHIELD
2537PMEDICARE PINMARYLAND
333760001OTHERMARYLANDBLUE CHOICE
4405788100MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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