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Individual
BENJAMIN LANE DAHL
Active
Individual
BENJAMIN LANE DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
11490
ND
2085R0202X
Diagnostic Radiology Physician
11490
ND
390200000X
Student in an Organized Health Care Education/Training Program
2004015303
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15406
—
ND
Enumeration date
06/12/2007
Last updated
11/23/2020
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