Healthcare Provider Details

I. General information

NPI: 1922292549
Provider Name (Legal Business Name): RENEU WOMENS HEALTH & MEDISPA LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 04/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W359N5002 BROWN ST SUITE 208
OCONOMOWOC WI
53066-3366
US

IV. Provider business mailing address

W359N5002 BROWN ST SUITE 208
OCONOMOWOC WI
53066-3366
US

V. Phone/Fax

Practice location:
  • Phone: 262-560-1920
  • Fax:
Mailing address:
  • Phone: 262-560-1920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUZANNE CLARE SCHMIDT
Title or Position: MD OBGYN ONE OF THE OWNERS
Credential: MD
Phone: 262-560-1920