Individual
JOHN N RENNEBURG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 LYONS ST, DEDHAM, MA 02026-5599
(781) 329-1400
(781) 461-8691
Mailing address
1 LYONS ST, DEDHAM, MA 02026-5599
(781) 329-1400
(781) 461-8691
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
70756
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200021
EVERCARE
—
01
—
27197
HEALTHY START
—
01
—
3100588
MEDICAID WELFARE
—
05
—
3100588
—
MA
01
—
5930251
AETNA US HEALTHCARE
—
01
—
7107816
CIGNA HEALTH PLAN
—
01
—
784075
MVP HEALTH CARE
—
01
—
919279
FIRST HEALTH
—
01
—
9900291
FALLON COMMUNITY HEALTH P
—
01
—
AA2169
HARVARD PILGRIM HEALTHCAR
—
01
—
J13537
BLUE SHIELD HMO BLUE
—
Enumeration date
02/16/2006
Last updated
07/08/2007
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