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Individual
TIMOTHY R BENAC
Active
Individual
TIMOTHY R BENAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9953
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160186500
—
MN
Enumeration date
02/08/2006
Last updated
03/22/2024
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