Individual
DR. MATTHEW RENDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
88 MDG/SGHJ, 4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(816) 885-9531
Mailing address
88 MDG/SGHJ, 4881 SUGAR MAPLE DR., WRIGHT PATTERSON AFB, OH 45433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
72143
TN
207RH0000X
Hematology (Internal Medicine) Physician
72143
TN
207RH0003X
Hematology & Oncology Physician
Primary
0101264008
VA
207RH0003X
Hematology & Oncology Physician
72143
TN
208D00000X
General Practice Physician
010264008
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101264008
TRICARE
VA
Enumeration date
02/25/2016
Last updated
12/10/2024
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