Provider Demographics
NPI:1528299468
Name:BENDER, JOEL REED (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:REED
Last Name:BENDER
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 1:47970 RAVELLO CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9821
Mailing Address - Country:US
Mailing Address - Phone:313-665-1642
Mailing Address - Fax:313-665-1652
Practice Address - Street 1:300 RENAISSANCE DRIVE
Practice Address - Street 2:MC 482-C10-092
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48265
Practice Address - Country:US
Practice Address - Phone:313-665-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010829272083X0100X
OH35059559B2083X0100X
TNMD00000143182083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine