Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Benedict John Frederick IV

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1134863772

Benedict John Frederick IV is a Psychiatry in Livonia, Michigan. Graduated from Western Michigan Un Homer Stryker School of Med in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Michigan.

Years since qualifying
4
Trained at
Western Michigan Un Homer Stryker School of Med
Licensed in
MI
In the registry since
2022
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Practice location Address checks out

19000 St Joes Pkwy Ste 310
Livonia, MI 48152-1477
Phone: (734) 743-4540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (MI)

Record details

NPI number1134863772
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 20, 2022
Last updated in NPPESApril 20, 2022
Certification dateApril 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolWESTERN MICHIGAN UN HOMER STRYKER SCHOOL OF MED
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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