Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 65721 | MN |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD60656156 | WA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD60656156 | WA |
NPI | 1922241371 |
---|---|
Provider Name | Dr. Terrie-Ann Sanya Benjamin |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Saint Paul, MN 55102-1062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2009 |
Last Update Date | 04/06/2020 |