Diaczok, Benjamin John

Diaczok, Benjamin John is an individual health care provider with primary practice located at 22255 Greenfield Rd 410, Southfield MI 48075-3710. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Diaczok, Benjamin John can be contacted via phone (248) 849-2850.

Contact Information

Primary practice address
22255 Greenfield Rd 410 Southfield MI 48075-3710
Phone: (248) 849-2850
Fax: (248) 849-5751
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301050499 Michigan

Profile Details

NPI number 1760480834
LBN Legal business name Diaczok, Benjamin John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Mar 7th, 2023 - about 3 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 1760480834 NPPES
Michigan Other 4301050499 CONTROLLED SUBSTANCE

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