Provider Demographics
NPI:1710943956
Name:PERKIS, RENEE LYNN (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:PERKIS
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 151
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-0151
Mailing Address - Country:US
Mailing Address - Phone:302-652-2455
Mailing Address - Fax:
Practice Address - Street 1:404 FOXHUNT DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2538
Practice Address - Country:US
Practice Address - Phone:302-652-2455
Practice Address - Fax:302-322-6252
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDE6737OtherMEDICARE RAILROAD GROUP
MDP00308151OtherMEDICARE RAILROAD
MDDE6737OtherMEDICARE RAILROAD GROUP
MDP00308151OtherMEDICARE RAILROAD
MD077NMedicare PIN
MD228P490GMedicare PIN