Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125-056283 | IL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 29683 | OK |
NPI | 1124255922 |
---|---|
Provider Name | Benjamin Joseph Barenberg |
First Address | Oklahoma City, OK 73114-6304 |
Second Address | Oklahoma City, OK 73114-6304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 19/09/2018 |