Provider Demographics
NPI:1023009487
Name:BENEKOS, EMILY L (MD)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:L
Last Name:BENEKOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 WINTER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2300
Mailing Address - Country:US
Mailing Address - Phone:330-345-2229
Mailing Address - Fax:330-345-2236
Practice Address - Street 1:546 WINTER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2300
Practice Address - Country:US
Practice Address - Phone:330-345-2229
Practice Address - Fax:330-345-2236
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072445B207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH141935OtherHEALTHAMERICA
OH733579OtherBUCKEYE ID
OH311537968028OtherCARESOURCE ID
OH000000121558OtherANTHEM BC/BS
OH0701759OtherUNITED HEALTHCARE
OH2082304OtherAETNA HMO
OH2018775Medicaid
OH35072445BOtherUNICARE
OH5624549OtherAETNA PPO
OH0701759OtherUNITED HEALTHCARE
OHBE0835741Medicare PIN
OHG62622Medicare UPIN