Provider Demographics
NPI:1922292549
Name:RENEU WOMENS HEALTH & MEDISPA LTD
Entity Type:Organization
Organization Name:RENEU WOMENS HEALTH & MEDISPA LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OBGYN ONE OF THE OWNERS
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:CLARE
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-560-1920
Mailing Address - Street 1:W359N5002 BROWN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3366
Mailing Address - Country:US
Mailing Address - Phone:262-560-1920
Mailing Address - Fax:
Practice Address - Street 1:W359N5002 BROWN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3366
Practice Address - Country:US
Practice Address - Phone:262-560-1920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21316400Medicaid