MEDICARE: DR. MICHAEL J RENNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	038594	GA

General Provider Information

NPI Number	:	1386602662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J RENNER M.D.

Provider Business Mailing Address
First Line	:	4300 N POINT PKWY STE 300
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-4102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	127 OLD HIGHWAY 96 STE B
Second Line	:
City	:	BONAIRE
State	:	GA
Zip	:	31005-3461
Country	:	US
Telephone Number	:	478-352-7143
Fax Number	:	478-352-7144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/13/2025

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