Benjamin David Lack (NPI# 1740592146, PAC ID# 8527299288) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1740592146 |
| PAC ID by PECOS | 8527299288 |
| Professional Enrollment ID | I20150911002013 |
| Full Name | Benjamin David Lack |
| Organization Legal Name | HENRY FORD HEALTH SYSTEM |
| Address |
2333 Biddle Ave Wyandotte MI 48192-4668 |
| Phone Number | 7342466064 |
| Gender | M |
| Medical School | DUKE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2010 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 0547178311 |
| Number of Group Practice Members | 1861 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230053 | HENRY FORD HOSPITAL |
| 230302 | HENRY FORD WEST BLOOMFIELD HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2333 Biddle Ave, Wyandotte, MI 48192-4668 | 7342466064 | HENRY FORD HEALTH SYSTEM |
| Organization Legal Name | HENRY FORD HEALTH SYSTEM |
| Physicians | 2034 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vneshe Parekh | Family Medicine | Henry Ford Health System | 6620 Highland Rd, Suite 101, Waterford, MI 48327-1682 |
| Kristin Marika Work | Nurse Practitioner | Henry Ford Health System | 6773 W Maple Rd, West Bloomfield, MI 48322-3013 |
| Komal Dhanoa | Family Medicine | Henry Ford Health System | 22505 Allen Rd, Woodhaven, MI 48183-2237 |
| Kristen Horner Angster | Otolaryngology | Henry Ford Health System | 14500 Hall Rd, Sterling Heights, MI 48313-1229 |
| Andrew R Larson | Internal Medicine | Henry Ford Health System | 1265 N Milford Rd, Milford, MI 48381-1018 |
| Shera C Thompson | Nurse Practitioner | Henry Ford Health System | 45 Grand River Ave, Detroit, MI 48226-1701 |
| Lisa S Zetuna | Certified Registered Nurse Anesthetist (crna) | Henry Ford Health System | 2799 W Grand Boulevard, Detroit, MI 48202-2608 |
| Jarida Begum | Nurse Practitioner | Henry Ford Health System | 159 Kercheval Ave, Grosse Pointe, MI 48236-3610 |
| Brett T Tolpa | Certified Registered Nurse Anesthetist (crna) | Henry Ford Health System | 2333 Biddle, Wyandotte, MI 48192-4668 |
| Katherine Cybinski | Family Medicine | Henry Ford Health System | 7800 W Outer Dr, Detroit, MI 48235-3461 |
| Street Address |
2333 BIDDLE AVE |
| City | WYANDOTTE |
| State | MI |
| Zip | 48192-4668 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Evan A Gillo | Physician Assistant | Hospitalist Physicians Medical Group of Michigan, PC | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Mary E Mitchell | Physician Assistant | Hospitalist Physicians Medical Group of Michigan, PC | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Mark I Pensler | Pulmonary Disease | 2333 Biddle Ave, Wyandotte, MI 48192-4668 | |
| Jessica L Corcoran | Emergency Medicine | Epmg Downriver Pllc | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Paul D Havenstein | Anesthesiology | Metropolitan Anesthesia Consultants, Pllc | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Jeffrey W Callard | Physician Assistant | Hospitalist Physicians Medical Group of Michigan, PC | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Monica C Gunter | Psychologist, Clinical | Henry Ford Wyandotte Hospital | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Jennifer L Havenstein | Certified Registered Nurse Anesthetist (crna) | Henry Ford Wyandotte Hospital | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Sonya Marie Elgammal | Anesthesiology | Metropolitan Anesthesia Consultants, Pllc | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Abdulilah Obeid | Physician Assistant | Hospitalist Physicians Medical Group of Michigan, PC | 2333 Biddle Ave, Wyandotte, MI 48192-4668 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacinto O Kadour Rodriguez | Internal Medicine | Ravinder Gandhi Md PC | 2025 Ford Ave, Suite 100, Wyandotte, MI 48192-2301 |
| Girish Mangalick | Neurology | 1623 Ford Ave, Wyandotte, MI 48192-2303 | |
| Malini Venkatram | Rheumatology | 1623 Ford Ave, Wyandotte, MI 48192-2303 | |
| Nsima M Usen | Podiatry | Khalil and Usen Dpm, PC | 1628 Ford Ave, Wyandotte, MI 48192-2304 |
| Mohammad F Khalil | Podiatry | Khalil and Usen Dpm, PC | 1628 Ford Ave, Wyandotte, MI 48192-2304 |
| Audey Nasser | Podiatry | Khalil and Usen Dpm, PC | 1628 Ford Ave, Wyandotte, MI 48192-2304 |
| Alexandria M Marshall | Podiatry | Khalil and Usen Dpm, PC | 1628 Ford Ave, Wyandotte, MI 48192-2304 |
| Brian Mcmanus | Podiatry | Khalil and Usen Dpm, PC | 1628 Ford Ave, Wyandotte, MI 48192-2304 |
| Ernest E Sorenson | Podiatry | Khalil and Usen Dpm, PC | 1628 Ford Ave, Wyandotte, MI 48192-2304 |
| Ibrahim H Dabaja | Physician Assistant | Wyandotte Urgent Care Clinic | 1768 Ford Ave, Wyandotte, MI 48192-2306 |
| Find all physicians in zip 48192 | |||
| City | WYANDOTTE |
| Zip Code | 48192 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | WYANDOTTE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Benjamin David Lack.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.