Provider Demographics
NPI:1053372433
Name:BENSON, PETER J (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:J
Last Name:BENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 385760
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-5760
Mailing Address - Country:US
Mailing Address - Phone:952-944-0970
Mailing Address - Fax:952-303-6713
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-520-5521
Practice Address - Fax:763-520-1721
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2010-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN29693207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E56918Medicare UPIN