Provider Demographics
NPI:1437240140
Name:BENECK, STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BENECK
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 1:2006 FOULK RD STE B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3644
Mailing Address - Country:US
Mailing Address - Phone:302-529-8783
Mailing Address - Fax:302-529-7470
Practice Address - Street 1:2006 FOULK RD STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3644
Practice Address - Country:US
Practice Address - Phone:302-529-8783
Practice Address - Fax:302-529-7470
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004585208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250008131OtherRAILROAD MEDICARE
DE0000681801Medicaid
DE0975123OtherAETNA-HMO
DE510329923OtherUNITED HEALTH CARE
DE439833OtherAMERIHEALTH-PPO
DE4832427OtherCIGNA
DE510329923OtherTRICARE STANDARD
DE4398882OtherAETNA - PPO
DE293737OtherMAMSI/OPTIMUM CHOICE
DE386606954OtherBC/BS
DEP1860867OtherOXFORD HEALTH PLAN
DE0000681801OtherDE PHYSICIAN CARE
DE46958OtherCOVENTRY
DE0283766000OtherAMERIHEALTH HMO
DE439833OtherAMERIHEALTH-PPO
DE386606954OtherBC/BS