Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 02184 | IA |
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 9901001 | NC |
NPI | 1114944907 |
---|---|
Provider Name | Dr. Eric J Rentz |
First Address | Morrisville, NC 27560-7757 |
Second Address | Banner Elk, NC 28604-6802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 28/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BR0518829 | DEA NUMBER (01) | |
E32318 | (02) |