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NPI Code Detail

MEDICARE: JEFFREY A BENDER M.D.

MEDICARE: JEFFREY A BENDER M.D.
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
1207P00000XEmergency Medicine Physician4301074016MI
2207Q00000XFamily Medicine Physician4301074016MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881618205
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY A BENDER M.D.
Provider Business Mailing Address
First Line : 303 DEVON DR
Second Line :
City : SAINT LOUIS
State : MI
Zip : 48880-9428
Country : US
Telephone Number : 906-643-8585
Fax Number : 906-643-0463
Provider Business Practice Location Address
First Line : 220 BURDETTE ST
Second Line :
City : SAINT IGNACE
State : MI
Zip : 49781-1712
Country : US
Telephone Number : 906-643-8585
Fax Number : 906-643-0463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 02/26/2008

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Directions to “ JEFFREY A BENDER M.D.” Practice Location

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