Healthcare Provider Details

I. General information

NPI: 1851338131
Provider Name (Legal Business Name): RENEWALMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MOHAWK ST SUITE A
SAVANNAH GA
31419
US

IV. Provider business mailing address

900 MOHAWK ST SUITE A
SAVANNAH GA
31419-1780
US

V. Phone/Fax

Practice location:
  • Phone: 912-920-2090
  • Fax:
Mailing address:
  • Phone: 912-920-2090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BARBARA KEEL
Title or Position: PATIENT ACCOUNT MANAGER
Credential: CPC, CPB, CPRC
Phone: 912-920-5624