Healthcare Provider Details

I. General information

NPI: 1437100500
Provider Name (Legal Business Name): MICHAEL F BENAVAGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MAIN ST
CATASAUQUA PA
18032-2646
US

IV. Provider business mailing address

1605 N CEDAR CREST BLVD SUITE 110B
ALLENTOWN PA
18104-2351
US

V. Phone/Fax

Practice location:
  • Phone: 610-264-0411
  • Fax: 610-264-8498
Mailing address:
  • Phone: 610-973-1410
  • Fax: 610-973-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD027619E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: