Provider Demographics
NPI:1033190996
Name:BENAVIDES, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:BENAVIDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:816 22ND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2226
Mailing Address - Country:US
Mailing Address - Phone:308-865-2557
Mailing Address - Fax:308-865-1461
Practice Address - Street 1:816 22ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2226
Practice Address - Country:US
Practice Address - Phone:308-865-2557
Practice Address - Fax:308-865-1461
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE21231207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE72887Medicare UPIN