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General NPI Number Information
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NPI Number | 1962533844
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Entity Type | Organization
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Legal Business Name | A. BENAVIDES, M.D., INC.
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1004 SUSHRUTA DR SUITE B
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City | MARTINSBURG
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State | WV
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Zip | 25401-8898
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Country | US
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Telephone | 304-263-4949
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Fax | 304-263-8725
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Provider Business Mailing Address
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Address Line | 1004 SUSHRUTA DR SUITE B
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City | MARTINSBURG
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State | WV
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Zip | 25401-8898
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Country | US
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Telephone | 304-263-4949
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Fax | 304-263-8725
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AURELIO BENAVIDES
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Credential | M.D.
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Telephone | 304-263-4949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 10389
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License Number State | WV
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