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General NPI Number Information
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NPI Number | 1851554554
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Entity Type | Organization
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Legal Business Name | MAX BENZAQUEN MD PC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 224 S WOODS MILL RD SUITE 290 SOUTH
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3451
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Country | US
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Telephone | 314-878-8744
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Fax | 314-878-2234
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Provider Business Mailing Address
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Address Line | 224 S WOODS MILL RD SUITE 290 SOUTH
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3451
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Country | US
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Telephone | 314-878-8744
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Fax | 314-878-2234
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Authorized Official
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Title or Position | OWNER
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Name | MAX P BENZAQUEN
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Credential | MD
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Telephone | 314-878-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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