Provider Demographics
NPI:1922254069
Name:SEFCIK, BENJAMIN D (DPM)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:D
Last Name:SEFCIK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 N. PERRY STREET
Mailing Address - Street 2:POH REGIONAL MEDICAL CENTER
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2253
Mailing Address - Country:US
Mailing Address - Phone:248-338-5392
Mailing Address - Fax:248-338-5567
Practice Address - Street 1:50 N. PERRY STREET
Practice Address - Street 2:POH REGIONAL MEDICAL CENTER
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2253
Practice Address - Country:US
Practice Address - Phone:248-338-5392
Practice Address - Fax:248-338-5567
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5901002272213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist