MEDICARE: DANIEL J BENZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301077285	MI

General Provider Information

NPI Number	:	1982686234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J BENZ M.D.

Provider Business Mailing Address
First Line	:	6327 BURLINGAME ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48204-1301
Country	:	US
Telephone Number	:	314-888-5233
Fax Number	:	203-590-8644

Provider Business Practice Location Address
First Line	:	6327 BURLINGAME ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48204-1301
Country	:	US
Telephone Number	:	314-888-5233
Fax Number	:	203-590-8644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	01/18/2023

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