Provider Demographics
NPI:1568183796
Name:HILLEBRAND, BENJAMIN MARC
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:MARC
Last Name:HILLEBRAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 15TH AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-3426
Mailing Address - Country:US
Mailing Address - Phone:701-330-3683
Mailing Address - Fax:
Practice Address - Street 1:7014 15TH AVE S
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-3426
Practice Address - Country:US
Practice Address - Phone:701-330-3683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program