Provider Demographics
NPI:1568576841
Name:NILAN, RENEE M (MD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:M
Last Name:NILAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RENEE
Other - Middle Name:M
Other - Last Name:SPARLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-0446
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:4200 WHITEHALL DR STE 150
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105
Practice Address - Country:US
Practice Address - Phone:734-995-0308
Practice Address - Fax:734-995-0425
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066614207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4221780Medicaid
MI4221780Medicaid
G80632Medicare UPIN