Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5101025173 | MI |
N | 111NI0900X | Internist | 5101025173 | MI |
Y | 207RC0200X | Critical Care Medicine | 5101025173 | MI |
N | 207RP1001X | Pulmonary Disease | 5101025173 | MI |
NPI | 1093151177 |
---|---|
Provider Name | Megan Benedict |
First Address | Kalamazoo, MI 49007-5341 |
Second Address | Kalamazoo, MI 49007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2013 |
Last Update Date | 30/08/2019 |