Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 274295 | MA |
N | 207P00000X | Emergency Physician | 35.129598 | OH |
Y | 207RC0200X | Critical Care Medicine | 274295 | MA |
NPI | 1023437837 |
---|---|
Provider Name | Mr. Benjamin Christian Renne II |
First Address | Boston, MA 02111-1639 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 25/06/2020 |