Individual
GAGE PATRICK RENSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16910 FRANCES ST, OMAHA, NE 68130-2398
(402) 505-8777
(402) 933-7767
Mailing address
16910 FRANCES ST, OMAHA, NE 68130-1750
(402) 505-8777
(402) 933-7767
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34596
NE
390200000X
Student in an Organized Health Care Education/Training Program
0406
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490466211
PASSPORT
—
01
—
H13221442
DRIVER'S LICENSE
NE
Enumeration date
04/02/2018
Last updated
08/16/2022
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