Individual
BENJAMIN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E LANCASTER AVE STE B11, WYNNEWOOD, PA 19096
(484) 476-2658
(484) 476-3577
Mailing address
100 E LANCASTER AVE STE B11, WYNNEWOOD, PA 19096-3450
(484) 476-2658
(484) 476-3577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD461715
PA
208M00000X
Hospitalist Physician
MD461715
PA
Other
Enumeration date
04/10/2015
Last updated
08/29/2018
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