Provider Demographics
NPI:1861874364
Name:DR. JOSEPH P. BENDER P.C.
Entity type:Organization
Organization Name:DR. JOSEPH P. BENDER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-448-7114
Mailing Address - Street 1:8226 ACKER HWY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:49247-9303
Mailing Address - Country:US
Mailing Address - Phone:517-448-7114
Mailing Address - Fax:
Practice Address - Street 1:8226 ACKER HWY
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MI
Practice Address - Zip Code:49247-9303
Practice Address - Country:US
Practice Address - Phone:517-448-7114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033420261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
0462720Medicare PIN