Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 51326 | TN |
Y | 2080P0202X | Pediatric Cardiologist | E-11155 | AR |
NPI | 1073806618 |
---|---|
Provider Name | Dr. Markus Stephan Renno |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 06/08/2018 |