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1356575864 NPI number — CAROL DEANE BENEDICT MD

NPI Number: 1356575864
Health Care Provider/Practitioner: CAROL DEANE BENEDICT MD

Information about “1356575864” NPI (CAROL DEANE BENEDICT MD) exists in 1356575864 in HTML format HTML  |  1356575864 in plain Text format TXT  |  1356575864 in PDF (Portable Document Format) PDF  |  1356575864 in an XML format XML  formats.

NPI Number : 1356575864 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356575864",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BENEDICT",
    "FirstName": "CAROL DEANE",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MITNICK",
    "OtherFirstName": "CAROL DEANE",
    "OtherMiddleName": "BENEDICT",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3800 RESERVOID RD. NW SUITE 3004",
    "SecondLineMailingAddress": "PHC 3RD FLOOR, DIV. OF RHEUM, GEORGETOWN UNIVERSITY HOS",
    "MailingAddressCityName": "WASHINGTON",
    "MailingAddressStateName": "DC",
    "MailingAddressPostalCode": "22102",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "202-444-6200",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3800 RESERVOIR RD NW SUITE 3004",
    "SecondLinePracticeLocationAddress": "PHC 3RD FLOOR, DIV. OF RHEUM, GEORGETOWN UNIVERSITY HOS",
    "PracticeLocationAddressCityName": "WASHINGTON",
    "PracticeLocationAddressStateName": "DC",
    "PracticeLocationAddressPostalCode": "20007-2113",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "202-444-6200",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/12/2009",
    "LastUpdateDate": "10/04/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RR0500X",
          "TaxonomyName": "Rheumatology Physician",
          "LicenseNumber": "MD040698",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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