Provider Demographics
NPI:1093734816
Name:BENSSON, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:BENSSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 STURDY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3148
Mailing Address - Country:US
Mailing Address - Phone:508-236-8360
Mailing Address - Fax:508-222-8075
Practice Address - Street 1:28 STURDY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3148
Practice Address - Country:US
Practice Address - Phone:508-236-8360
Practice Address - Fax:508-222-8075
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
6689OtherHPHC
B10039901OtherCIGNA
004244OtherRIBC
056728OtherTUFTS
MA3084043Medicaid
0402002OtherUHC
33238OtherFALLON
MAJ06044OtherMABC
000000028149OtherBMC HEALTHNET
33238OtherFALLON
MA3084043Medicaid