MEDICARE: BENJAMIN RENTFROW DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	5101016918	MI

General Provider Information

NPI Number	:	1962618751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN RENTFROW DO

Provider Business Mailing Address
First Line	:	25823 CLINTON SHORE DR
Second Line	:
City	:	HARRISON TWP
State	:	MI
Zip	:	48045-1501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 LAMB CIR STE 380
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-6345
Country	:	US
Telephone Number	:	540-510-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	12/10/2020

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