Individual
BENJAMIN M MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 384-6800
(937) 384-6839
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
45040
KY
Other
Enumeration date
08/14/2009
Last updated
10/22/2012
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