| Richard H Benninger Md Pc | |
|
833 Michigan St Ne Ste 101, Grand Rapids, MI 49503-2578 | |
| (616) 459-3713 | |
| (616) 459-3716 |
| Full Name | Richard H Benninger Md Pc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 833 Michigan St Ne Ste 101, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275618068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4901003291 (Michigan) | Secondary |
| 207W00000X | Ophthalmology | 4301030073 (Michigan) | Primary |
| Provider Name | Heidi Marie Gordon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144272618 PECOS PAC ID: 5294747846 Enrollment ID: I20060622000220 |
| Provider Name | Richard Hugh Benninger |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275530909 PECOS PAC ID: 8123111895 Enrollment ID: I20070911000736 |
| Provider Name | Jason Frederick Vanderploeg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558404152 PECOS PAC ID: 6103913801 Enrollment ID: I20071026000678 |
| Provider Name | Amber L Bowen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780971101 PECOS PAC ID: 7719159227 Enrollment ID: I20111005000520 |
| Provider Name | Sarah Kay Hansen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083902845 PECOS PAC ID: 5193988319 Enrollment ID: I20120524000642 |
| Provider Name | Carrie M Dewolfe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184283285 PECOS PAC ID: 2567878424 Enrollment ID: I20210302000315 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard H Benninger Md Pc 833 Michigan St Ne Ste 101, Grand Rapids, MI 49503-2578 Ph: (616) 459-3713 | Richard H Benninger Md Pc 833 Michigan St Ne Ste 101, Grand Rapids, MI 49503-2578 Ph: (616) 459-3713 |