Individual
BENJAMIN JOHN HYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-1840
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
229232
MA
207RG0100X
Gastroenterology Physician
Primary
229232
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2162555
—
MA
Enumeration date
04/19/2006
Last updated
11/05/2010
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