Bautista, Benjamin Genesis M
Bautista, Benjamin Genesis M is an individual health care provider with primary practice located at 855 N Westhaven Dr , Oshkosh WI 54904-7668. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Bautista, Benjamin Genesis M can be contacted via phone (920) 456-7400.Contact Information
Primary practice address
855 N Westhaven Dr
Oshkosh WI 54904-7668
Phone: (920) 456-7400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 54794 | Wisconsin |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036130758 | Illinois |
Profile Details
| NPI number | 1396051561 |
|---|---|
| LBN Legal business name | Bautista, Benjamin Genesis M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2010 |
| Last updated | Jul 10th, 2017 - about 8 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 | 1396051561 | NPPES |
| Illinois | Other | 036130758 | IL STATE LICENSE |
Popular Providers
-
Gale, Daniel
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Veling, Tyler J
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Strait, Paul Stephen
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Chancey, Christopher Doyel
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Spychalla, Zechariah David
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Strobel, Zachary
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Thompson, Christopher C
855 N Westhaven Dr , Oshkosh WI 54904-7668 -
Polglaze, Kevin L
855 N Westhaven Dr , Oshkosh WI 54904-7668