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General NPI Number Information
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NPI Number | 1255639225
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Entity Type | Organization
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Legal Business Name | RENEE R EGER MD LLC
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Dates
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Enumeration Date | 03/01/2011
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 1 RANDALL SQ SUITE 205
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City | PROVIDENCE
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State | RI
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Zip | 02904-2709
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Country | US
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Telephone | 401-331-6980
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RANDALL SQ SUITE 205
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City | PROVIDENCE
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State | RI
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Zip | 02904-2709
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Country | US
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Telephone | 401-331-6980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RENEE R EGER
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Credential | MD
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Telephone | 401-331-6980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | RI8636
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License Number State | RI
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