Provider Demographics
NPI:1407896921
Name:CATRAMBONE, RENEE LINDAHL (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LINDAHL
Last Name:CATRAMBONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:46591 ROMEO PLANK RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-5705
Mailing Address - Country:US
Mailing Address - Phone:586-226-6250
Mailing Address - Fax:586-226-6255
Practice Address - Street 1:46591 ROMEO PLANK RD STE 205
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5705
Practice Address - Country:US
Practice Address - Phone:586-226-6250
Practice Address - Fax:586-226-6255
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095985208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G11627Medicare UPIN
MIMI10143005-MI10143Medicare PIN
NJ0012157Medicaid