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Individual

DR. EUGENE GEORGE BENEDICT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
802 E FRONT ST, SUITE 2, BUCHANAN, MI 49107-1499
(269) 695-9011
(269) 695-2251
Mailing address
802 E FRONT ST, SUITE 2, BUCHANAN, MI 49107-1499
(269) 695-9011
(269) 695-2251

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
18001440A
IN
152W00000X
Optometrist
Primary
4901002243
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5014457
MI
Enumeration date
07/07/2006
Last updated
01/14/2013
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