Provider Demographics
NPI:1083097349
Name:PETERKIN-MCCALMAN, RENEE (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PETERKIN-MCCALMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:PETERKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:811 13TH ST STE 14
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2771
Mailing Address - Country:US
Mailing Address - Phone:706-828-0043
Mailing Address - Fax:706-828-0450
Practice Address - Street 1:811 13TH ST STE 14
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2771
Practice Address - Country:US
Practice Address - Phone:706-828-0043
Practice Address - Fax:706-828-0450
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008150207R00000X
GA80917207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine