Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MD.24889 | AL |
NPI | 1184800948 |
---|---|
Provider Name | Delano Benjamin |
First Address | Forestdale, AL 35214-3034 |
Second Address | Forestdale, AL 35214-3034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 03/05/2018 |