Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 010123629 | VA |
NPI | 1023164522 |
---|---|
Provider Name | William J Beneke |
First Address | Williamsburg, VA 23188-8213 |
Second Address | Williamsburg, VA 23188-8213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010077061 | (05) | VA |
F33759 | (02) |