Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 34277 | MN |
NPI | 1932192457 |
---|---|
Provider Name | Benhoor Soumekh |
First Address | Minneapolis, MN 55404-3753 |
Second Address | Minneapolis, MN 55404-3753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 17/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1000010 | MEDICA PRIMARY (01) | MN |
1000110 | MEDICA CHOICE (01) | MN |
1011165 | PREFERRED ONE (01) | MN |
111715 | UCARE (01) | |
111715 | UCARE (01) | MN |
25905 | AMERICA'S PPO (01) | MN |
32281600 | (05) | WI |
62D65S0 | BLUE SHIELD (01) | MN |
639406000 | (05) | MN |
E86446 | (02) | MN |