Provider Demographics
NPI:1477146926
Name:MCLAUGHLIN, RENEE HALEY (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:HALEY
Last Name:MCLAUGHLIN
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 185
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:MI
Mailing Address - Zip Code:49816-0185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4724 TAKKINEN ROAD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:MI
Practice Address - Zip Code:49816-0185
Practice Address - Country:US
Practice Address - Phone:906-439-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076987208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty