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NPI Code Detail

MEDICARE: EDWIN RAY RENDER M.D.

MEDICARE: EDWIN RAY RENDER M.D.
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
1207L00000XAnesthesiology Physician28837KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457345191
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWIN RAY RENDER M.D.
Provider Business Mailing Address
First Line : PO BOX 909
Second Line :
City : LOUISVILLE
State : KY
Zip : 40201-0909
Country : US
Telephone Number : 502-588-0328
Fax Number :
Provider Business Practice Location Address
First Line : 1850 BLUEGRASS AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40215-1161
Country : US
Telephone Number : 502-852-5851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 01/15/2026

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