Dr. Benigno Rafael Elejalde
Clinical Genetics (M.D.)
2311 W Good Hope Rd
Glendale
, Wisconsin 53209-2735
Dr. Benigno Rafael Elejalde
Clinical Genetics (M.D.)
2311 W Good Hope Rd
Glendale
, Wisconsin 53209-2735
(414) 228-8774
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About
Features
Specialties
- Clinical Genetics (M.D.)
Languages spoken
- English
Location
First Address
- Dr. Benigno Rafael Elejalde
- 1626 W Fond Du Lac Ave # 110
- Milwaukee, WI
- Zip : 53205-1228
- Fax : (414) 228-8774
- Phone : (414) 228-0100
Second Address
- Dr. Benigno Rafael Elejalde
- 2311 W Good Hope Rd
- Glendale, WI
- Zip : 53209-2735
- Fax : (414) 228-8774
- Phone : (414) 228-0100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207SG0201X | Clinical Genetics (M.D.) | 21932 | WI |
National Provider Identifier
| NPI | 1598705279 |
|---|---|
| Provider Name | Dr. Benigno Rafael Elejalde |
| First Address | Milwaukee, WI 53205-1228 |
| Second Address | Glendale, WI 53209-2735 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/06/2006 |
| Last Update Date | 15/12/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000002018 | MEDICARE ID (01) | WI |
| 30207400 | (05) | WI |
| E23866 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.