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General NPI Number Information
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NPI Number | 1255561189
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Entity Type | Individual
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Provider Name | MOHAMMED TAOUDI BENCHEKROUN MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 3601 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073
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Country | US
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Telephone | 248-898-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 W 13 MILE RD 400 FSC/PCS
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City | ROYAL OAK
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State | MI
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Zip | 48073
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 51642
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 51642
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 51642
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License Number State | SC
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