Dalton Mark Renick, DO in Roanoke, VA - Medicare Pediatrics

Dalton Mark Renick, DO is a medicare enrolled "Pediatrics" physician in Roanoke, Virginia. His current practice location is 4040 Postal Dr, Roanoke, Virginia. You can reach out to his office (for appointments etc.) via phone at (540) 772-4453.

Dalton Mark Renick is licensed to practice in Virginia (license number 0102206530) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174013932.

Contact Information

	Dalton Mark Renick, DO
	4040 Postal Dr, Roanoke, VA 24018-6438
	(540) 772-4453
	(540) 772-4717

Physician's Profile

Full Name	Dalton Mark Renick
Gender	Male
Speciality	Pediatrics
Location	4040 Postal Dr, Roanoke, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174013932
Provider Enumeration Date: 05/16/2018
Last Update Date: 08/18/2022

Medicare PECOS Information:

PECOS PAC ID: 1951646686
Enrollment ID: I20211117002648

Medical Identifiers

Medical identifiers for Dalton Mark Renick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174013932	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	LL51961 (South Carolina)	Secondary
208000000X	Pediatrics	0102206530 (Virginia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dalton Mark Renick is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dalton Mark Renick, DO 213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713 Ph: (540) 224-5715	Dalton Mark Renick, DO 4040 Postal Dr, Roanoke, VA 24018-6438 Ph: (540) 772-4453

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Pediatrics Doctors in Roanoke, VA

Kevin Leal, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1906 Belleview Ave Se, Roanoke, VA 24014 Phone: 540-981-7000
Camron L Johnson Privitera, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21 Highland Ave Se, Ste 100, Roanoke, VA 24013 Phone: 540-344-9213 Fax: 540-345-7559
Robert C Gard, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21 Highland Ave Se, Ste 100, Roanoke, VA 24013 Phone: 540-344-9213 Fax: 540-345-7559
Joseph Tamez, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 4348 Electric Rd, Roanoke, VA 24018 Phone: 540-769-0976 Fax: 540-857-5393
Kaitlyn Bixel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1906 Belleview Ave Se, Roanoke, VA 24014 Phone: 540-224-4635 Fax: 540-985-9099
Susan Smith, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 89 Summers Way, Roanoke, VA 24019 Phone: 540-992-1251
Dr. Erinn E Hokanson, NP Pediatrics Medicare: Medicare Enrolled Practice Location: 4348 Electric Rd, Roanoke, VA 24018 Phone: 540-769-0975 Fax: 540-772-8219

Dalton Mark Renick, DO - Medicare Pediatrics in Roanoke, VA