Provider Demographics
NPI:1740887173
Name:RICE, BENJAMIN HOLT (MD)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:HOLT
Last Name:RICE
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 1:4464 RALSTON DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-1519
Mailing Address - Country:US
Mailing Address - Phone:218-722-8634
Mailing Address - Fax:
Practice Address - Street 1:4464 RALSTON DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-1519
Practice Address - Country:US
Practice Address - Phone:218-722-8634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056787207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine