Individual
BENJAMIN C GILLEN
Active
Individual
BENJAMIN C GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
51114
MN
2085R0202X
Diagnostic Radiology Physician
Primary
63398
WI
2085R0204X
Vascular & Interventional Radiology Physician
01072278A
IN
2085R0204X
Vascular & Interventional Radiology Physician
63398
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002569
—
WI
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
06/23/2008
Last updated
06/20/2024
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