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General NPI Number Information
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NPI Number | 1871600437
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Entity Type | Organization
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Legal Business Name | DR. BENEDICT AND ASSOCIATES, P.C.
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 8392 HOLLY RD
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City | GRAND BLANC
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State | MI
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Zip | 48439-1867
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Country | US
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Telephone | 810-694-9903
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Fax | 810-695-6644
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Provider Business Mailing Address
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Address Line | PO BOX 78000 DEPARTMENT NUMBER 78085
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City | DETROIT
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State | MI
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Zip | 48278-0001
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Country | US
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Telephone | 810-694-9903
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Fax | 810-695-6644
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ORLANDO IVAN BENEDICT
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Credential | M.D.
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Telephone | 810-694-9903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 4301060730
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License Number State | MI
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