Dagan, Benigno Waldo A

Dagan, Benigno Waldo A is an sole proprietor health care provider with primary practice located at 1420 Main St , Sumner WA 98390. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Dagan, Benigno Waldo A can be contacted via phone (253) 987-5156.

Contact Information

Primary practice address
1420 Main St Sumner WA 98390
Phone: (253) 987-5156
Fax: (253) 987-5462
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00036169 Washington

Profile Details

NPI number 1235182122
LBN Legal business name Dagan, Benigno Waldo A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 19th, 2006
Last updated May 10th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235182122 NPPES
Washington Other 5496722 AETNA PROVIDER NUMBER
Washington Other 0185591 AETNA PROVIDER NUMBER
Washington MEDICAID 2004507 AETNA PROVIDER NUMBER
Washington Other 98390A015 AETNA PROVIDER NUMBER
Washington Other 9869DA AETNA PROVIDER NUMBER
Washington Other 911203494BP AETNA PROVIDER NUMBER

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