Fogal, Benjamin J
Fogal, Benjamin J is an individual health care provider with primary practice located at 9801 Dupont Ave S Ste 200 , Bloomington MN 55431-3200. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Fogal, Benjamin J can be contacted via phone (952) 888-5800.Contact Information
Primary practice address
9801 Dupont Ave S Ste 200
Bloomington MN 55431-3200
Phone: (952) 888-5800
Fax: (952) 567-6156
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 3019 | Minnesota |
Profile Details
| NPI number | 1730174822 |
|---|---|
| LBN Legal business name | Fogal, Benjamin J |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2005 |
| Last updated | Sep 15th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730174822 | NPPES |
| Minnesota | Other | P00362877 | RAILROAD MEDICARE |
| Minnesota | MEDICAID | 769412100 | RAILROAD MEDICARE |
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