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NPI Code Detail

MEDICARE: RICHARD PIERCE RENKA MD

MEDICARE: RICHARD PIERCE RENKA 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
12084P0800XPsychiatry Physician2225SD

Other Identifiers

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

General Provider Information

NPI Number : 1801882287
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD PIERCE RENKA MD
Provider Business Mailing Address
First Line : 528 QUINCY ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-3628
Country : US
Telephone Number : 605-348-5401
Fax Number : 605-348-7319
Provider Business Practice Location Address
First Line : 528 QUINCY ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-3628
Country : US
Telephone Number : 605-348-5401
Fax Number : 605-348-7319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 07/08/2007

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