Provider Demographics
NPI:1235186024
Name:ARNETZ, BENGT B (MD)
Entity Type:Individual
Prefix:
First Name:BENGT
Middle Name:B
Last Name:ARNETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1420 STEPHENSON HWY
Mailing Address - Street 2:SUITE 400 - CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1189
Mailing Address - Country:US
Mailing Address - Phone:248-581-5974
Mailing Address - Fax:248-581-5640
Practice Address - Street 1:26400 W 12 MILE RD
Practice Address - Street 2:SUITE 111
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1771
Practice Address - Country:US
Practice Address - Phone:248-359-8073
Practice Address - Fax:248-359-8036
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2014-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 604662083P0500X
MA503472083X0100X
MI43010848022083X0100X
NY176142-12083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P30630405Medicare PIN