Individual
BENJAMIN J POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 S EAGLE RD, SUITE 3102, MERIDIAN, ID 83642-6351
(208) 706-5100
(208) 706-5169
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(919) 668-2360
(919) 668-1300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2005-00536
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005-00536
MEDICAL LICENSE
NC
Enumeration date
07/28/2006
Last updated
12/19/2012
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