Individual
BENJAMIN WALLACE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(865) 342-8940
Mailing address
13001 E 17TH PL, AURORA, CO 80045-2570
(303) 724-1765
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
62124
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2013
Last updated
07/21/2022
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