Individual
BENJAMIN T DASTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01062307
IN
207W00000X
Ophthalmology Physician
Primary
5484681
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000069325
PTAN (SELF)
UT
05
—
1073797809
—
UT
Enumeration date
12/28/2007
Last updated
10/09/2025
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