Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301027234 | MI |
Y | 2080P0006X | Developmental - Behavioral Pediatrician | 4301027234 | MI |
N | 2084N0402X | Child Neurologist | 430127234 | MI |
NPI | 1326086448 |
---|---|
Provider Name | David Benjamins |
First Address | Detroit, MI 48201-2153 |
Second Address | Detroit, MI 48201-2119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 16/11/2011 |