MEDICARE: STEVEN BENEDICT M.D.

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	35075012	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00062349	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11211354	OTHER	OH	CAQH
2	04235	OTHER	OH	PARAMOUNT
4	249285	OTHER	OH	ANTHEM INS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	7992074	OTHER	OH	AETNA INS

General Provider Information

NPI Number	:	1982676789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN BENEDICT M.D.

Provider Business Mailing Address
First Line	:	611 FULTON ST STE F
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-2008
Country	:	US
Telephone Number	:	419-820-9719
Fax Number	:	419-820-9720

Provider Business Practice Location Address
First Line	:	611 FULTON ST STE F
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-2008
Country	:	US
Telephone Number	:	419-820-9719
Fax Number	:	419-820-9720

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	08/18/2025

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Directions to “ STEVEN BENEDICT M.D.” Practice Location

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