Provider Demographics
NPI:1750329041
Name:MCKINNEY, RENEE M (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 INDEPENDENCE DR
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3628
Mailing Address - Country:US
Mailing Address - Phone:617-541-6520
Mailing Address - Fax:617-541-6444
Practice Address - Street 1:291 INDEPENDENCE DR
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3628
Practice Address - Country:US
Practice Address - Phone:617-541-6520
Practice Address - Fax:617-541-6444
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA217369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA35530Medicare PIN