Provider Demographics
NPI:1992227169
Name:RENAUD, NEIL PHILIP (OD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:PHILIP
Last Name:RENAUD
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1121 OTTAWA BEACH RD STE 140
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-2528
Mailing Address - Country:US
Mailing Address - Phone:616-848-7548
Mailing Address - Fax:616-848-7558
Practice Address - Street 1:1121 OTTAWA BEACH RD STE 140
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-2528
Practice Address - Country:US
Practice Address - Phone:616-848-7548
Practice Address - Fax:616-848-7558
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4901005159152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy