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NPI Code Detail

MEDICARE: RENEE C BOVELLE M.D.

MEDICARE:   RENEE C BOVELLE  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
1207WX0120XCornea and External Diseases Specialist PhysicianMD32558DC
2207W00000XOphthalmology PhysicianD0056686MD

General Provider Information

NPI Number : 1588732424
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE C BOVELLE M.D.
Provider Business Mailing Address
First Line : 12200 ANNAPOLIS RD STE 116
Second Line :
City : GLENN DALE
State : MD
Zip : 20769-9182
Country : US
Telephone Number : 301-805-4664
Fax Number : 301-805-4663
Provider Business Practice Location Address
First Line : 12200 ANNAPOLIS RD
Second Line : SUITE 116
City : GLENN DALE
State : MD
Zip : 20769-9182
Country : US
Telephone Number : 301-805-4664
Fax Number : 301-805-4663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 06/29/2023

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Directions to “ RENEE C BOVELLE M.D.” Practice Location

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