Healthcare Provider Details

I. General information

NPI: 1578258083
Provider Name (Legal Business Name): BENJAMIN ESPENHORST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EVERGREEN DR STE 310
GLEN MILLS PA
19342-1059
US

IV. Provider business mailing address

300 EVERGREEN DR STE 310
GLEN MILLS PA
19342-1059
US

V. Phone/Fax

Practice location:
  • Phone: 610-579-3444
  • Fax: 610-579-3449
Mailing address:
  • Phone: 610-579-3444
  • Fax: 610-579-3449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD495963
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: