Individual
BENSON RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 BODART ST, GREEN BAY, WI 54301-4923
(920) 437-9773
Mailing address
622 BODART ST, GREEN BAY, WI 54301-4923
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
14817
WI
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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