Vanraalte, Benjamin

Vanraalte, Benjamin is an sole proprietor health care provider with primary practice located at 4334 E 53Rd St , Davenport IA 52807-3039. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Vanraalte, Benjamin can be contacted via phone (563) 322-8877.

Contact Information

Primary practice address
4334 E 53Rd St Davenport IA 52807-3039
Fax: (563) 322-8375
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 29526 Iowa

Profile Details

NPI number 1528048451
LBN Legal business name Vanraalte, Benjamin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2006
Last updated Jan 29th, 2020 - about 5 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 1528048451 NPPES
Iowa MEDICAID IA0113241

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