Healthcare Provider Details

I. General information

NPI: 1427638915
Provider Name (Legal Business Name): LEAH GLASPY BENTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UPPER CHESAPEAKE DR
BEL AIR MD
21014-4324
US

IV. Provider business mailing address

2360 W JOPPA RD STE 224
LUTHERVILLE MD
21093-4664
US

V. Phone/Fax

Practice location:
  • Phone: 443-643-1400
  • Fax:
Mailing address:
  • Phone: 410-644-4320
  • Fax: 410-368-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD0105066
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: