Healthcare Provider Details

I. General information

NPI: 1891739363
Provider Name (Legal Business Name): BENJAMIN P RECHNER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 PARCHMENT DR SE
GRAND RAPIDS MI
49546-3659
US

IV. Provider business mailing address

985 PARCHMENT DR SE
GRAND RAPIDS MI
49546-3659
US

V. Phone/Fax

Practice location:
  • Phone: 616-942-9260
  • Fax: 616-942-1971
Mailing address:
  • Phone: 616-942-9260
  • Fax: 616-942-1971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number4301070249
License Number StateMI

VIII. Authorized Official

Name: DR. BENJAMIN P RECHNER
Title or Position: PRESIDENT
Credential: MD
Phone: 616-942-9260