Doctor, Benedict A

Doctor, Benedict A is an individual health care provider with primary practice located at 100 Michigan St Ne Mc 035, Grand Rapids MI 49503-2560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Doctor, Benedict A can be contacted via phone (616) 391-1714.

Contact Information

Primary practice address
100 Michigan St Ne Mc 035 Grand Rapids MI 49503-2560
Phone: (616) 391-1714
Fax: (616) 391-1332
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 4301075630 Michigan

Profile Details

NPI number 1164494878
LBN Legal business name Doctor, Benedict A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Mar 21st, 2011 - about 14 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 1164494878 NPPES
Michigan MEDICAID 4203389

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