Provider Demographics
NPI:1427186469
Name:BENESH, BRUCE L (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:L
Last Name:BENESH
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 1:144 BARLEY SHEAF DR
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5303
Mailing Address - Country:US
Mailing Address - Phone:610-731-3379
Mailing Address - Fax:
Practice Address - Street 1:144 BARLEY SHEAF DR
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-5303
Practice Address - Country:US
Practice Address - Phone:610-731-3379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-024186-E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD LIC MD-024186-EOtherMD LIC #
PAMD LIC MD-024186-EOtherMD LIC #
PAUPIN F29093Medicare UPIN
PAMD LIC MD-024186-EOtherMD LIC #