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General NPI Number Information
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NPI Number | 1841229127
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Entity Type | Individual
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Provider Name | MICHAELA ELAINE RENICH MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1926 COTTON GROVE RD
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City | LEXINGTON
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State | NC
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Zip | 27292-5722
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Country | US
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Telephone | 336-242-1228
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Fax | 336-242-1393
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 336-242-1228
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Fax | 336-242-1393
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 98-01460
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License Number State | NC
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