Individual
IVOR J. BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DIVISION OF CARDIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-6633
(414) 805-6280
Mailing address
9200 W WISCONSIN AVE, DIVISION OF CARDIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-6633
(414) 805-6280
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
5409926-1205
UT
207RC0000X
Cardiovascular Disease Physician
Primary
61070
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851481485
—
WI
01
—
P00063496
RAILROAD MEDICARE
UT
Enumeration date
10/13/2006
Last updated
08/18/2022
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