Benjamin Maximilian Vannorden Tartter, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Kettering, Ohio. His current practice location is
3525 Southern Blvd, Kettering, Ohio. You can reach out to his office (for appointments etc.) via phone at
(937) 395-8839.
Benjamin Maximilian Vannorden Tartter is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720668031.
Physician's Profile
Full Name | Benjamin Maximilian Vannorden Tartter |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3525 Southern Blvd, Kettering, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1720668031
- Provider Enumeration Date: 04/11/2021
- Last Update Date: 03/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 9032528872
- Enrollment ID: I20210507002197
Medical Identifiers
Medical identifiers for Benjamin Maximilian Vannorden Tartter such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720668031 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 320722 (New York) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Benjamin Maximilian Vannorden Tartter is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Benjamin Maximilian Vannorden Tartter, 3525 Southern Blvd, Kettering, OH 45429-1221 Ph: (937) 395-8839 | Benjamin Maximilian Vannorden Tartter, 3525 Southern Blvd, Kettering, OH 45429-1221 Ph: (937) 395-8839 |
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