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General NPI Number Information
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NPI Number | 1982941423
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Entity Type | Organization
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Legal Business Name | BENIGN DIAGNOSTICS
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 7858 BEECHCRAFT AVE
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City | GAITHERSBURG
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State | MD
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Zip | 20879-1542
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Country | US
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Telephone | 301-787-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 15807 CHAGALL TER
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-3461
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Country | US
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Telephone | 301-787-1216
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. VAIDEHI KANNAN
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Credential | M.D
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Telephone | 301-787-1218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1832
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License Number State | MD
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