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NPI Code Detail

MEDICARE: DR. REGIO T PENNA MD

MEDICARE: DR. REGIO T PENNA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist4301044989MI
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician4301044989MI

General Provider Information

NPI Number : 1417930702
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REGIO T PENNA MD
Provider Business Mailing Address
First Line : 274 E CHICAGO ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-2041
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 274 E CHICAGO ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-2041
Country : US
Telephone Number : 517-279-5400
Fax Number : 419-866-5453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 12/09/2013

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Directions to “ DR. REGIO T PENNA MD” Practice Location

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