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Individual

ELIZABETH S BENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 926-8571
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
38153
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260027755
RAILROAD MEDICARE
WI
05
32247200
WI
Enumeration date
10/28/2005
Last updated
04/29/2024
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