Basic Information
Provider Information
NPI: 1376508457
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HSU
FirstName: BENSON
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5074
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571175074
CountryCode: US
TelephoneNumber: 6053286585
FaxNumber: 6053286512
Practice Location
Address1: 1600 W 22ND ST
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571051521
CountryCode: US
TelephoneNumber: 6053121000
FaxNumber: 6053121001
Other Information
ProviderEnumerationDate: 04/20/2006
LastUpdateDate: 03/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X1553WIN Allopathic & Osteopathic PhysiciansPediatrics 
208000000X50600WIN Allopathic & Osteopathic PhysiciansPediatrics 
208M00000X50600WIN Allopathic & Osteopathic PhysiciansHospitalist 
2080P0203X8023SDY Allopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine

No ID Information.


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