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General NPI Number Information
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NPI Number | 1013445337
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Entity Type | Organization
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Legal Business Name | BEN HERMAN ALLIANCE, LLC
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 05/31/2017
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Provider Practice Location Address
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Address Line | 2711 CENTERVILLE RD STE 400
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City | WILMINGTON
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State | DE
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Zip | 19808-1645
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Country | US
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Telephone | 480-266-9258
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 CENTERVILLE ROAD, SUITE 400 PNB #622
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City | WILMINGTON
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State | DE
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Zip | 19808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | STEFAN TARLOW
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Credential | MD
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Telephone | 480-266-9258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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