Healthcare Provider Details

I. General information

NPI: 1649362815
Provider Name (Legal Business Name): AMHERST FAMILY PRACTICE P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1867 AMHERST STREET
WINCHESTER VA
22601
US

IV. Provider business mailing address

1867 AMHERST STREET
WINCHESTER VA
22601
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-8724
  • Fax: 540-723-0741
Mailing address:
  • Phone: 540-667-8724
  • Fax: 540-723-0741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM J BENDER
Title or Position: PRESIDENT
Credential: MD
Phone: 540-667-8724