Doctor Name: | RICHARD RENNER |
NPI Number: | 1184670101 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | 0075P |
Business Practice Address: | 255 Route 108 Somersworth, NH - 038781543 |
Business Phone Number: | 6036924018 |
Business Fax Number: | 6036921083 |
Mailing Address: | 255 Route 108, SOMERSWORTH |
State: | NH |
Postal Code: | 038781543 |
Phone Number: | 6036924018 |
Fax Number: | 6036921083 |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 04/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0075P |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |