Provider Demographics
NPI:1447233283
Name:BENDER, GEORGE JESSE III (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JESSE
Last Name:BENDER
Suffix:III
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 1:11 VANDERBILT PARK DR
Mailing Address - Street 2:MEMORIAL HOSPITAL OF RHODE ISLAND
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1700
Mailing Address - Country:US
Mailing Address - Phone:401-729-2000
Mailing Address - Fax:
Practice Address - Street 1:111 BREWSTER STREET
Practice Address - Street 2:MEMORIAL HOSPITAL OF RHODE ISLAND
Practice Address - City:PAWTUCKER
Practice Address - State:RI
Practice Address - Zip Code:02860-1400
Practice Address - Country:US
Practice Address - Phone:401-729-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD112112080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGB51684Medicaid
RIGB51684Medicaid
RI007058144Medicare ID - Type UnspecifiedMEDICARE NUMBER