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NPI Code Detail

MEDICARE: MELISA A BENHAM MD

MEDICARE: MELISA A BENHAM 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
1207R00000XInternal Medicine PhysicianH0156TX

General Provider Information

NPI Number : 1871558429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISA A BENHAM MD
Provider Business Mailing Address
First Line : 209 SPEIGHT AVE
Second Line :
City : WACO
State : TX
Zip : 76706-1507
Country : US
Telephone Number : 254-710-1010
Fax Number : 254-710-2499
Provider Business Practice Location Address
First Line : 209 SPEIGHT AVE
Second Line :
City : WACO
State : TX
Zip : 76706-1507
Country : US
Telephone Number : 254-710-1010
Fax Number : 254-710-2499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2006
Last Update Date : 07/09/2007

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Directions to “ MELISA A BENHAM MD” Practice Location

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