Rengo, Rena Burlingame
Rengo, Rena Burlingame is an individual health care provider with primary practice located at 203 Indigo Dr , Brunswick GA 31525-6865. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Rengo, Rena Burlingame can be contacted via phone (912) 261-2669.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 2008-00705 | North Carolina |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | 2008-00705 | North Carolina |
Profile Details
| NPI number | 1053591602 |
|---|---|
| LBN Legal business name | Rengo, Rena Burlingame |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 13th, 2007 |
| Last updated | Dec 14th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053591602 | NPPES |
| North Carolina | Other | 148U6 | BCBS OF NC |
| North Carolina | Other | P00445423 | BCBS OF NC |
| North Carolina | MEDICAID | 5909325 | BCBS OF NC |
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