Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 64313 | MN |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 73208-20 | WI |
NPI | 1346771920 |
---|---|
Provider Name | Benjamin Eli Mishler Rosenstein |
First Address | Saint Paul, MN 55106-2824 |
Second Address | Saint Paul, MN 55106-2824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2017 |
Last Update Date | 09/08/2021 |