Individual
DR. ABRAHAM BENAVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
(719) 557-5872
(719) 557-4780
Mailing address
902 LAKEVIEW AVE, PUEBLO, CO 81004-3597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
TL.0007818
CO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TL.0007818
CO
Other
Enumeration date
04/12/2019
Last updated
05/28/2019
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