Individual
BENJAMIN R HANISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Mailing address
720 W LAKE ST, APT 201, MINNEAPOLIS, MN 55408-2963
(612) 666-1141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
58043
MN
Other
Enumeration date
07/21/2008
Last updated
07/23/2014
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