Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | D0042376 | MD |
N | 208000000X | Pediatrician | D0042376 | MD |
NPI | 1780054643 |
---|---|
Provider Name | Dr. Owen Murray Rennert |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2015 |
Last Update Date | 04/10/2015 |