Provider Demographics
NPI:1366446023
Name:RENSCH, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:RENSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 290647
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-0647
Mailing Address - Country:US
Mailing Address - Phone:507-995-0537
Mailing Address - Fax:830-257-0049
Practice Address - Street 1:420 WATER ST
Practice Address - Street 2:SUITE 103
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5200
Practice Address - Country:US
Practice Address - Phone:830-496-0111
Practice Address - Fax:830-257-0049
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43232207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN132562OtherUCARE
P00244346OtherRR MEDICARE
MNHP47841OtherHEALTH PARTNERS
MN081039800Medicaid
MN2900408OtherMEDICA
TX00RM40OtherMEDICARE GROUP
053038OtherIOWA MA
41084933956001C224OtherCHAMPUS TRICARE
MN638R4REOtherBCBS
MN1042781OtherPREFERRED ONE
MN2316539OtherAMERICAS PPO
053038OtherIOWA MA
MN638R4REOtherBCBS
MN1042781OtherPREFERRED ONE
TX8799B6Medicare PIN