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General NPI Number Information
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NPI Number | 1629167622
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Entity Type | Individual
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Provider Name | BENJAMIN MICHAEL LERNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 2801 W KINNICKINNIC RIVER PKWY
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City | MILWAUKEE
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State | WI
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Zip | 53215-3669
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Country | US
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Telephone | 414-649-3370
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Fax | 414-385-2461
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 101470-875
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60164818
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 50044
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 46881
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License Number State | WI
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