Individual
BENJAMIN SCOTT HUNGERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, CD
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8000
Mailing address
6037 240TH AVE, SALEM, WI 53168-9609
(262) 995-5484
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
5160-29
WI
133V00000X
Registered Dietitian
Primary
86085019
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5160-29
CERTIFIED DIETITIAN LICENSE
WI
01
—
86085019
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
01/23/2024
Last updated
01/23/2024
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