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Individual

BENJAMIN CARMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1548
(515) 282-2200
Mailing address
225 E CENTER ST APT 222, DES MOINES, IA 50309-1875
(970) 692-4719

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
110220
IA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/06/2020
Last updated
09/16/2021
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