Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA09516000 | NJ |
N | 111NI0900X | Internist | 25MA09516000 | NJ |
N | 207R00000X | Internist | 276976 | NY |
N | 111NI0900X | Internist | 276976 | NY |
Y | 207RI0011X | Interventional Cardiology | 83922 | GA |
NPI | 1093009425 |
---|---|
Provider Name | Dr. Max Benson |
First Address | Brooklyn, NY 11215-3609 |
Second Address | Cumming, GA 30041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2011 |
Last Update Date | 07/05/2021 |