Provider Demographics
NPI:1407962178
Name:BENSON, DON MICHAEL SR (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:MICHAEL
Last Name:BENSON
Suffix:SR
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 1:131 VICARY HILL LN NE
Mailing Address - Street 2:CANTON
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-1240
Mailing Address - Country:US
Mailing Address - Phone:330-493-0448
Mailing Address - Fax:
Practice Address - Street 1:3975 EMBASSY PARKWAY SUITE 202A
Practice Address - Street 2:AKRON
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333
Practice Address - Country:US
Practice Address - Phone:330-670-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35028774174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist