Individual
STEPHEN J BENEDICT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4665 DOUGLAS CIR NW, SUITE 101, CANTON, OH 44718-3673
(330) 489-1698
(330) 489-1325
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN141639
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000135914
ANTHEM
—
05
—
0751262
—
OH
01
—
430046901
MEDICARE RAILROAD
—
Enumeration date
05/18/2006
Last updated
08/26/2008
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