MEDICARE: DR. MARY ELISABETH BENJAMIN 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	207R00000X	Internal Medicine Physician	D0048252	MD

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	:	1801066824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ELISABETH BENJAMIN MD

Provider Business Mailing Address
First Line	:	12162 TECH RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1914
Country	:	US
Telephone Number	:	301-681-6654
Fax Number	:	301-681-2607

Provider Business Practice Location Address
First Line	:	12162 TECH RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1914
Country	:	US
Telephone Number	:	301-681-6654
Fax Number	:	301-681-2607

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

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	10/26/2023

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