Bajuyo, Benito Colanco

Bajuyo, Benito Colanco is an sole proprietor health care provider with primary practice located at 1204 W 10Th St , Metropolis IL 62960-2433. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Bajuyo, Benito Colanco can be contacted via phone (618) 524-3572.

Contact Information

Primary practice address
1204 W 10Th St Metropolis IL 62960-2433
Phone: (618) 524-3572
Fax: (618) 524-3496
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 036048476 Illinois

Profile Details

NPI number 1770703779
LBN Legal business name Bajuyo, Benito Colanco
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2007
Last updated Dec 19th, 2018 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770703779 NPPES
Illinois Other 262914 HEALTHLINK
Illinois Other 6400025 HEALTHLINK
Illinois MEDICAID 036048476 HEALTHLINK
Illinois Other 020024057 HEALTHLINK

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