Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD-45803 | IA |
N | 111NI0900X | Internist | MD-45803 | IA |
N | 207RI0200X | Infectious Disease | 2015035775 | MO |
Y | 207RI0200X | Infectious Disease | MD-45803 | IA |
NPI | 1013205285 |
---|---|
Provider Name | Dr. Lemuel Benedict R Non |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 27/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | IL |