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NPI Code Detail

MEDICARE: BEN HERMAN ALLIANCE, LLC

MEDICARE: BEN HERMAN ALLIANCE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1013445337
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEN HERMAN ALLIANCE, LLC
Provider Business Mailing Address
First Line : 2711 CENTERVILLE ROAD, SUITE 400
Second Line : PNB #622
City : WILMINGTON
State : DE
Zip : 19808
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2711 CENTERVILLE RD STE 400
Second Line :
City : WILMINGTON
State : DE
Zip : 19808-1645
Country : US
Telephone Number : 480-266-9258
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : STEFAN TARLOW
Credential : MD
Telephone Number : 480-266-9258
Provider Enumeration Date : 05/31/2017
Last Update Date : 05/31/2017

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Directions to “BEN HERMAN ALLIANCE, LLC ” Practice Location

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