Individual
DR. CHANCE BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
221 MICHIGAN ST NE STE 300, GRAND RAPIDS, MI 49503-2537
(616) 459-7258
Mailing address
2104 NORTHVIEW CT NE, GRAND RAPIDS, MI 49525-1269
(513) 262-8794
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
HS000102L
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
5101028055
MI
390200000X
Student in an Organized Health Care Education/Training Program
HS000102L
PA
Other
Enumeration date
06/02/2018
Last updated
07/02/2024
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