Healthcare Provider Details

I. General information

NPI: 1376104869
Provider Name (Legal Business Name): JAMES RICHARD BENKE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 UPPER CHESAPEAKE DR STE 201
BEL AIR MD
21014-4360
US

IV. Provider business mailing address

520 UPPER CHESAPEAKE DR STE 201
BEL AIR MD
21014-4360
US

V. Phone/Fax

Practice location:
  • Phone: 410-598-8188
  • Fax:
Mailing address:
  • Phone: 443-643-3800
  • Fax: 443-643-3856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number5151013716
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberH0104268
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5151013716
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: