Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10063399 | TX |
N | 111NI0900X | Internist | BP10063399 | TX |
NPI | 1003312729 |
---|---|
Provider Name | Benjamin Behnoud Nia |
First Address | Washington, DC 20060-0001 |
Second Address | Washington, DC 20060-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2018 |
Last Update Date | 09/09/2019 |