Healthcare Provider Details

I. General information

NPI: 1700895844
Provider Name (Legal Business Name): ALEXANDER B. BENSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 UNION BLVD STE 110
LAKEWOOD CO
80228-1836
US

IV. Provider business mailing address

274 UNION BLVD STE 110
LAKEWOOD CO
80228-1836
US

V. Phone/Fax

Practice location:
  • Phone: 303-951-0600
  • Fax: 303-951-0605
Mailing address:
  • Phone: 303-951-0600
  • Fax: 303-951-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number45691
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: