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Individual

TAD T RENVYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
703 RIVERWAY PL, BEDFORD, NH 03110-6745
(603) 627-1661
(603) 669-6944
Mailing address
703 RIVERWAY PL, BEDFORD, NH 03110-6745
(603) 627-1661
(603) 669-6944

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11573
NH
2085R0202X
Diagnostic Radiology Physician
MD20616
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30202047
NH
Enumeration date
02/10/2006
Last updated
07/30/2025
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