Individual
ROBERT EDWARD RENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1102 FARMINGTON AVE, WEST HARTFORD, CT 06107-2163
(860) 521-1181
Mailing address
1102 FARMINGTON AVE, WEST HARTFORD, CT 06107-2163
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
008385
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010008385CT01
ANTHEM BLUE CROSS
CT
01
—
10445099
CAQH ID
CT
Enumeration date
06/27/2006
Last updated
07/09/2007
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