RENATO SIAZON LEE (NPI# 1114977725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114977725 |
| Entity Type | Individual |
| Full Name | RENATO SIAZON LEE |
| Credential | M.D. |
| Practice Address |
611 W Belle Ave Saint Charles MI 48655-1611 |
| Mailing Address |
611 W Belle Ave Po Box 160 Saint Charles MI 48655-1611 |
| Practice Telephone | 9898659958 |
| Practice Fax Number | 9898658099 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2009-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301055115 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS OF MICHIGAN ID | 0807341122 | 01 |
| MI | HEALTHPLUS OF MICHIGAN ID | 080G360680 | 01 |
| MI | 4348831 | 05 |
| Street Address |
611 W BELLE AVE |
| City | SAINT CHARLES |
| State | MI |
| Zip Code | 48655-1611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538635842 | Kimberly Truckner | Registered Nurse | 611 W Belle Ave, Saint Charles, MI 48655-1611 | 2018-10-15 |
| 1265893432 | St. Charles Family Clinic Pllc | Internal Medicine | 611 W Belle Ave, Saint Charles, MI 48655-1611 | 2016-03-15 |
| 1205295573 | Jillian Rodney | Nurse Practitioner | 611 W Belle Ave, Saint Charles, MI 48655-1611 | 2016-02-16 |
| 1134431778 | St Charles Family Practice Plc LLC | Family Medicine | 611 W Belle Ave, Saint Charles, MI 48655-1611 | 2010-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669837993 | St. Charles Family Clinic Pllc | Family Medicine | 611 W Belle Avenue, Saint Charles, MI 48655 | 2015-12-31 |
| 1023412889 | Rachel Wells | Licensed Practical Nurse | 223 W Belle Ave, St. Charles, MI 48655 | 2014-10-22 |
| 1194140962 | Dcs Management | Assisted Living Facility | 302 Fulton Street, Saint Charles, MI 48655 | 2014-03-03 |
| 1245297415 | St Charles Pharmacy LLC | Pharmacy | 1008 N Saginaw St, St. Charles, MI 48655 | 2006-04-29 |
| 1912391418 | Pat Bashans | Registered Nurse | 10797 Carr Road, Saint Charles, MI 48655-0105 | 2015-03-23 |
| 1841274909 | Ronald Gonzales Jr. | Family Medicine | 1124 N Saginaw St, Saint Charles, MI 48655-1021 | 2005-12-02 |
| 1154368439 | Ronald L Gonzales Md Pllc | Family Medicine | 1124 N Saginaw St, Saint Charles, MI 48655-1021 | 2006-06-02 |
| 1710432836 | Carrie Wilson | Pharmacist | 1008 N Saginaw St, Saint Charles, MI 48655-1022 | 2016-08-18 |
| 1154388320 | Laura Snellenberger | Pharmacist | 1008 N Saginaw St, Saint Charles, MI 48655-1022 | 2006-04-29 |
| 1134512262 | Tricia Douglas | Specialist/Technologist | 881 W Walnut St, Saint Charles, MI 48655-1257 | 2015-03-13 |
| Find all providers in zip 48655 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669837993 | St. Charles Family Clinic Pllc | Family Medicine | 611 W Belle Avenue, Saint Charles, MI 48655 | 2015-12-31 |
| 1922408426 | Total Access Urgent Care, PC | Family Medicine | 3871 Mexico Rd, Saint Charles, MO 63303-3042 | 2014-09-03 |
| 1154687077 | Elizabeth H Maylack | Family Medicine | 1551 Wall St Ste 400, Saint Charles, MO 63303-3541 | 2012-04-04 |
| 1164793360 | George William Pappas | Family Medicine | 525 Tyler Rd Ste J, Saint Charles, IL 60174-3363 | 2012-01-19 |
| 1407940513 | Hemalini Thakkar | Family Medicine | 2015 Dean St, #2, Saint Charles, IL 60174-1577 | 2006-10-03 |
| 1801903463 | Natan Lvovitch Khotianov | Family Medicine | 12 Tristan Ter, Saint Charles, MO 63303-4207 | 2006-08-23 |
| 1639180631 | Ssm Depaul Medical Group, Inc. | Family Medicine | 1821 Sherman Dr, Saint Charles, MO 63303-3984 | 2006-08-11 |
| 1235173378 | Dr. Eischen Clinic, P. C. | Family Medicine | 106 West Main Street, Suite 267, Saint Charles, IA 50240-0267 | 2006-06-16 |
| 1013981109 | Steven B Livingstone | Family Medicine | 711 Veterans Memorial Pkwy Ste 300, Saint Charles, MO 63303-2106 | 2006-02-15 |
| 1841274909 | Ronald Gonzales Jr. | Family Medicine | 1124 N Saginaw St, Saint Charles, MI 48655-1021 | 2005-12-02 |
| Find all providers in SAINT CHARLES | ||||
| City | SAINT CHARLES |
| Zip Code | 48655 |
Please comment or provide details below to improve the information on RENATO SIAZON LEE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.