Individual
GAGE PATRICK RENSCH
Active
Individual
GAGE PATRICK RENSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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