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General NPI Number Information
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NPI Number | 1023008182
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Entity Type | Organization
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Legal Business Name | PULMONARY AND CRITICAL CARE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 19455 DEERFIELD AVE STE 206
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City | LEESBURG
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State | VA
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Zip | 20176-8102
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Country | US
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Telephone | 703-858-9608
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Fax | 703-858-9618
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Provider Business Mailing Address
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Address Line | 19455 DEERFIELD AVE STE 206
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City | LEESBURG
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State | VA
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Zip | 20176-8102
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Country | US
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Telephone | 703-858-9608
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Fax | 703-858-9618
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS RENNERT
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Credential | M.D.
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Telephone | 703-858-9608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0101043761
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License Number State | VA
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