Individual
JEFFREY PAUL RENSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 S GREEN RD, SOUTH EUCLID, OH 44121-4136
(216) 297-3168
(216) 297-3169
Mailing address
211 LAKE COVE CT, BRATENAHL, OH 44108-1074
(216) 761-5931
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35055582
OH
207RP1001X
Pulmonary Disease Physician
Primary
35055582
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0882755
—
OH
Enumeration date
09/21/2005
Last updated
06/02/2008
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