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Individual

RICHARD RENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
255 ROUTE 108, SOMERSWORTH, NH 03878-1543
(603) 692-4018
(603) 692-1083
Mailing address
107 COMMERCIAL ST, MASHPEE, MA 02649-6507
(508) 539-6000
(508) 477-7028

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0075P
NH
363AM0700X
Medical Physician Assistant
Primary
PA633
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30003861
NH
Enumeration date
05/25/2006
Last updated
12/13/2024
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