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Individual
DR. JONATHAN BENJAMIN IDA
Active
Individual
DR. JONATHAN BENJAMIN IDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
MD.200263
LA
207YP0228X
Pediatric Otolaryngology Physician
Primary
1801070370
IL
207YP0228X
Pediatric Otolaryngology Physician
35.094270
OH
Other
Enumeration date
12/19/2007
Last updated
11/06/2018
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