Provider Demographics
NPI:1902150279
Name:BALDING, RENEE D (PHARMD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:D
Last Name:BALDING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:D
Other - Last Name:MARANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3250 US 41 W
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9483
Mailing Address - Country:US
Mailing Address - Phone:906-226-0095
Mailing Address - Fax:
Practice Address - Street 1:3250 US 41 W
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9483
Practice Address - Country:US
Practice Address - Phone:906-226-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist