Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 35573 | MN |
NPI | 1255300463 |
---|---|
Provider Name | Susan Benfield |
First Address | W. St. Paul, MN 55107-2226 |
Second Address | W. St. Paul, MN 55107-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 22/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101043 | MEDICA (01) | MN |
108289 | UCARE (01) | MN |
6T019BE | BCBS (01) | MN |
826083400 | (05) | MN |
F86177 | (02) | MN |
HP15873 | HEALTH PARTNERS (01) | MN |
NA9021019258 | PREFERRED ONE (01) | MN |