Healthcare Provider Details

I. General information

NPI: 1861029613
Provider Name (Legal Business Name): JENNIFER RENEE RENO MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHAEL LLEWELLYN RENO MD PHD

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5859 ABERCORN ST STE 3
SAVANNAH GA
31405-5530
US

IV. Provider business mailing address

5859 ABERCORN ST STE 3
SAVANNAH GA
31405-5530
US

V. Phone/Fax

Practice location:
  • Phone: 912-296-3744
  • Fax: 912-296-3590
Mailing address:
  • Phone: 912-296-3744
  • Fax: 912-296-3590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number30348
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number30348
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number98762
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number30348
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number98762
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number98762
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: