Provider Demographics
NPI:1578706354
Name:BENJAMIN, JOSHUA SELTON (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:SELTON
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 N HIGH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5503
Mailing Address - Country:US
Mailing Address - Phone:303-839-7440
Mailing Address - Fax:303-839-7210
Practice Address - Street 1:2055 N HIGH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5503
Practice Address - Country:US
Practice Address - Phone:303-839-7440
Practice Address - Fax:303-839-7210
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.00513202080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program