Healthcare Provider Details

I. General information

NPI: 1568751931
Provider Name (Legal Business Name): BENJAMIN JAY WORKMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 W WACKERLY ST
MIDLAND MI
48640-6922
US

IV. Provider business mailing address

2711 W WACKERLY ST
MIDLAND MI
48640-6922
US

V. Phone/Fax

Practice location:
  • Phone: 989-837-6868
  • Fax: 989-837-6837
Mailing address:
  • Phone: 989-837-6868
  • Fax: 989-837-6837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301099085
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: