MEDICARE: THOMAS CHARLES BENFIELD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD021016E	PA

General Provider Information

NPI Number	:	1932264215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CHARLES BENFIELD M.D.

Provider Business Mailing Address
First Line	:	19 KIRKDALE DR
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-2519
Country	:	US
Telephone Number	:	856-596-0835
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 CHESTNUT ST
Second Line	:	STE 1013
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4316
Country	:	US
Telephone Number	:	215-592-1223
Fax Number	:	215-592-4644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	07/08/2007

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