Holman, Benjamin M

Holman, Benjamin M is an individual health care provider with primary practice located at 6000 N Allen Road , Peoria IL 61614-3294. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Holman, Benjamin M can be contacted via phone (309) 691-1400.

Contact Information

Primary practice address
6000 N Allen Road Peoria IL 61614-3294
Phone: (309) 691-1400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085002725 Illinois

Profile Details

NPI number 1770507246
LBN Legal business name Holman, Benjamin M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Dec 31st, 2019 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770507246 NPPES
Illinois MEDICAID 085002725

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