Provider Demographics
NPI:1073620159
Name:VARNADO, BENITA WILLIAMS (MD)
Entity Type:Individual
Prefix:
First Name:BENITA
Middle Name:WILLIAMS
Last Name:VARNADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:BENITA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 E WENDOVER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1231
Mailing Address - Country:US
Mailing Address - Phone:336-268-3380
Mailing Address - Fax:336-268-3381
Practice Address - Street 1:301 E WENDOVER AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1231
Practice Address - Country:US
Practice Address - Phone:336-268-3380
Practice Address - Fax:336-268-3381
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200601191207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904981Medicaid
NC2054681Medicare PIN
NCI65888Medicare UPIN
NC5904981Medicaid