MEDICARE: KAUSHALYA BENIWAL M D S C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	25201	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447580881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAUSHALYA BENIWAL M D S C

Provider Business Mailing Address
First Line	:	2745 W LAYTON AVE
Second Line	:	SUITE 104
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-2651
Country	:	US
Telephone Number	:	414-282-1961
Fax Number	:

Provider Business Practice Location Address
First Line	:	2745 W LAYTON AVE
Second Line	:	SUITE 104
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-2651
Country	:	US
Telephone Number	:	414-282-1961
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KAUSHALYA BENIWAL
Credential	:	M.D.
Telephone Number	:	414-282-1961

Provider Enumeration Date	:	01/07/2010
Last Update Date	:	09/16/2025

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