Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | DR.0056852 | CO |
Y | 208600000X | Surgeon | DR.0056852 | CO |
N | 2086S0105X | Surgery of the Hand | DR.0056852 | CO |
NPI | 1316173008 |
---|---|
Provider Name | Dr. Benson Pulikkottil |
First Address | Augusta, GA 30914-2330 |
Second Address | Englewood, CO 80113-2702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 04/01/2022 |