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NPI Code Detail

MEDICARE: DR. ERIK BENSON RABORN DO MPH

MEDICARE: DR. ERIK BENSON RABORN DO MPH
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
1207RG0100XGastroenterology Physician14184SD

General Provider Information

NPI Number : 1417482225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIK BENSON RABORN DO MPH
Provider Business Mailing Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5474
Country : US
Telephone Number : 605-342-3280
Fax Number :
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5474
Country : US
Telephone Number : 605-342-3280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2017
Last Update Date : 06/08/2023

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