Doctor Name: | DR. PETER BENSON |
NPI Number: | 1255499281 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4301050262 |
Business Practice Address: | 1500 W Ice Lake Rd Iron River, MI - 499358509 |
Business Phone Number: | 9062655378 |
Business Fax Number: | 9062654245 |
Mailing Address: | 506 Campus Dr, HANCOCK |
State: | MI |
Postal Code: | 499301569 |
Phone Number: | 9064831705 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207KA0200X |
License Number: | 4301050262 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Allergy & Immunology |
Taxonomy Specialization: | Allergy |
Taxonomy Definition: |