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General NPI Number Information
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NPI Number | 1003839937
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Entity Type | Organization
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Legal Business Name | RALEIGH GYNECOLOGY & WELLNESS PA
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 2304 WESVILL CT SUITE 210
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City | RALEIGH
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State | NC
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Zip | 27607-2973
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Country | US
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Telephone | 919-782-6700
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Fax | 919-782-2218
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Provider Business Mailing Address
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Address Line | 2304 WESVILL CT SUITE 210
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City | RALEIGH
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State | NC
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Zip | 27607-2973
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Country | US
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Telephone | 919-782-6700
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Fax | 919-782-2218
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORENA BENAVIDES
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Credential | M.D.
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Telephone | 919-782-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 32213
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 36223
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2008-01471
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | CNM044 ACNM4360
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2006-00441
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License Number State | NC
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