MEDICARE: DAVID AARON BENEZRA MD

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	2084N0400X	Neurology Physician	0101269700	VA
2	2084N0600X	Clinical Neurophysiology Physician	0101269700	VA
3	2084E0001X	Epilepsy Physician	0101269700	VA

General Provider Information

NPI Number	:	1710338488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID AARON BENEZRA MD

Provider Business Mailing Address
First Line	:	5855 BREMO RD STE 207
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-1922
Country	:	US
Telephone Number	:	804-893-8656
Fax Number	:	804-287-7018

Provider Business Practice Location Address
First Line	:	5855 BREMO RD STE 207
Second Line	:	MOB NORTH SUITE 207
City	:	RICHMOND
State	:	VA
Zip	:	23226-1922
Country	:	US
Telephone Number	:	804-893-8656
Fax Number	:	804-287-7018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	11/18/2025

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