Maxwell Edward Rennaker (NPI# 1366934879, PAC ID# 9638402787) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1366934879 |
| PAC ID by PECOS | 9638402787 |
| Professional Enrollment ID | I20190605001769 |
| Full Name | Maxwell Edward Rennaker |
| Organization Legal Name | LAKESHORE EYECARE CENTER PC |
| Address |
4752 136th Ave Hamilton MI 49419-9015 |
| Phone Number | 6163950606 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 2018 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 1557424405 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4752 136th Ave, Hamilton, MI 49419-9015 | 6163950606 | LAKESHORE EYECARE CENTER PC |
| 2657 120th Ave, Holland, MI 49424-8692 | 6163950606 | LAKESHORE EYECARE CENTER PC |
| Organization Legal Name | LAKESHORE EYECARE CENTER PC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew Black | Optometry | Lakeshore Eyecare Center PC | 2657 120th Ave, Holland, MI 49424-8692 |
| Scott M Kass | Optometry | Lakeshore Eyecare Center PC | 11971 James St, Holland, MI 49424-9610 |
| Rebecca Ann Jacquemin | Optometry | Lakeshore Eyecare Center PC | 4752 136th Ave, Hamilton, MI 49419-9015 |
| William Scott Meengs | Optometry | Lakeshore Eyecare Center PC | 2657 120th Ave, Holland, MI 49424-8692 |
| Adam R Risko | Optometry | Lakeshore Eyecare Center PC | 4752 136th Ave, Hamilton, MI 49419-9015 |
| Street Address |
4752 136TH AVE |
| City | HAMILTON |
| State | MI |
| Zip | 49419-9015 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rebecca Ann Jacquemin | Optometry | Lakeshore Eyecare Center PC | 4752 136th Ave, Hamilton, MI 49419-9015 |
| Adam R Risko | Optometry | Lakeshore Eyecare Center PC | 4752 136th Ave, Hamilton, MI 49419-9015 |
| Dirk Schrotenboer | Optometry | Lakeshore Eyecare Center P C | 4752 136th Ave, Hamilton, MI 49419-9015 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Keith Slenk | Physical Therapy | West Michigan Rehabilitation PC | 3491 Lincoln M, Suite 40, Hamilton, MI 49419-9512 |
| Gordon L Roberts | Chiropractic | Dr Gordon L Roberts Pllc | 3426 Lincoln Rd, Hamilton, MI 49419-9512 |
| Mark A Hoffmeyer | Physical Therapy | West Michigan Rehabilitation PC | 3491 Lincoln M, Suite 40, Hamilton, MI 49419-9512 |
| Tara E Tomman | Chiropractic | Dr Gordon L Roberts Pllc | 3426 Lincoln Rd, Hamilton, MI 49419-9512 |
| Julie Kay Breining | Physical Therapy | West Michigan Rehabilitation PC | 3491 Lincoln M, Suite 40, Hamilton, MI 49419-9512 |
| Leonard R Fazio Jr. | Physical Therapy | West Michigan Rehabilitation PC | 3491 Lincoln M, Suite 40, Hamilton, MI 49419-9512 |
| City | HAMILTON |
| Zip Code | 49419 |
| Specialty | OPTOMETRY |
| City + Specialty | HAMILTON + OPTOMETRY |
Please comment or provide details below to improve the information on Maxwell Edward Rennaker.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.