Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101011084 | MI |
NPI | 1740248350 |
---|---|
Provider Name | Dr. James Ben Hengy |
First Address | Manistee, MI 49660-9363 |
Second Address | Manistee, MI 49660-9363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 11/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3178700 | (05) | MI |
F68339 | (02) | MI |