Provider Demographics
NPI:1093813867
Name:MUNARI, RENATE GABRIELE (MD)
Entity Type:Individual
Prefix:DR
First Name:RENATE
Middle Name:GABRIELE
Last Name:MUNARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-0850
Mailing Address - Country:US
Mailing Address - Phone:423-733-2131
Mailing Address - Fax:423-733-1055
Practice Address - Street 1:1861 MAIN ST
Practice Address - Street 2:
Practice Address - City:SNEEDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37869-3645
Practice Address - Country:US
Practice Address - Phone:423-733-2131
Practice Address - Fax:423-733-1055
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43110207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3001423Medicaid
WI45219-020OtherLICENSE
TN3001423Medicaid
3703865Medicare PIN
3001423Medicare PIN