Organization
DR. BENEDICT AND ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORLANDO IVAN BENEDICT M.D. (OWNER/PRESIDENT)
(810) 694-9903
Entity
Organization
Contact information
Practice address
8392 HOLLY RD, GRAND BLANC, MI 48439-1867
(810) 694-9903
(810) 695-6644
Mailing address
PO BOX 78000, DEPARTMENT NUMBER 78085, DETROIT, MI 48278-0001
(810) 694-9903
(810) 695-6644
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
4301060730
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080B51127
BLUE CROSS BLUE SHIELD
MI
05
—
4189664
—
MI
Enumeration date
08/23/2006
Last updated
07/28/2010
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