Adam Nikolaus Benckendorf, DO
Anesthesiology in Saint Louis, MO. Individual provider (NPI-1).
NPI number1801423652
StatusActive
Last updated in NPPESMay 30, 2024
Details
- NPI
- 1801423652
- Entity type
- Individual (NPI-1)
- Name
- Adam Nikolaus Benckendorf
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2020
- Certification date
- May 30, 2024
- Last updated
- May 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | 2024009634 | MO | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1402 S Grand Blvd # M260Saint Louis, MO 63104-1004
Phone 314-577-8933
Mailing address
4068 Federer StSaint Louis, MO 63116-2815
Phone 314-894-0021
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