Individual
BENJAMIN J BRONICEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1460 G ST, SPRINGFIELD, OR 97477-4112
(541) 726-4400
Mailing address
PO BOX 11840, WESTMINSTER, CA 92685-1840
(800) 511-4875
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD23040
OR
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
MD23040
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287655
—
OR
Enumeration date
05/22/2006
Last updated
11/30/2009
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