Provider Demographics
NPI:1235197971
Name:DEARMENT, RENA C (MD)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:C
Last Name:DEARMENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENA
Other - Middle Name:BETH
Other - Last Name:CUNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:875 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2203
Mailing Address - Country:US
Mailing Address - Phone:717-303-3588
Mailing Address - Fax:717-303-3589
Practice Address - Street 1:875 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 340
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2203
Practice Address - Country:US
Practice Address - Phone:717-303-3588
Practice Address - Fax:717-303-3589
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070084L207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018656850001Medicaid
PA49853Medicare ID - Type Unspecified
H44574Medicare UPIN