Provider Demographics
NPI:1922590298
Name:RENIER, JAMES MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:RENIER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:106 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1207
Mailing Address - Country:US
Mailing Address - Phone:320-251-5444
Mailing Address - Fax:
Practice Address - Street 1:22201 MOROSS ROAD
Practice Address - Street 2:SUITE 250 PROFESSIONAL BUILDING 2
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-3423
Practice Address - Fax:313-343-3401
Is Sole Proprietor?:No
Enumeration Date:2018-06-03
Last Update Date:2021-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN1078213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery