Basic Information
Provider Information
NPI: 1295703239
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIERRE-LOUIS
FirstName: RENAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2817 REILLY RD
Address2: MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER
City: FORT BRAGG
State: NC
PostalCode: 28310
CountryCode: US
TelephoneNumber: 9109078922
FaxNumber: 9109076069
Practice Location
Address1: 26 RIVIERA DR
Address2:  
City: PINEHURST
State: NC
PostalCode: 283745024
CountryCode: US
TelephoneNumber: 9102353713
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/08/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X9701547NCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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