Healthcare Provider Details

I. General information

NPI: 1033127626
Provider Name (Legal Business Name): RENUKA GERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE STE 145
LANSING MI
48912-1800
US

IV. Provider business mailing address

804 SERVICE RD STE A202
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-5440
  • Fax: 517-364-5409
Mailing address:
  • Phone: 517-364-5440
  • Fax: 517-364-5409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number4301045225
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: