Healthcare Provider Details

I. General information

NPI: 1114342318
Provider Name (Legal Business Name): EMILY BENZER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR MCHANEY HALL 404
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

3400 SPRUCE ST MCHANEY HALL 404
PHILADELPHIA PA
19104-4208
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-2000
  • Fax:
Mailing address:
  • Phone: 215-662-7320
  • Fax: 215-349-5917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS024786
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2015021901
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: