Bengtson, Ross B

Bengtson, Ross B is an individual health care provider with primary practice located at 2024 S 6Th St , Brainerd MN 56401-4529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bengtson, Ross B can be contacted via phone (218) 828-7100.

Contact Information

Primary practice address
2024 S 6Th St Brainerd MN 56401-4529
Phone: (218) 828-7100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 45928 Minnesota

Profile Details

NPI number 1417931593
LBN Legal business name Bengtson, Ross B
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Jan 7th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417931593 NPPES
Minnesota Other 45928 LICENSE NUMBER
Minnesota MEDICAID 667689800 LICENSE NUMBER

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