Provider Demographics
NPI:1558332684
Name:BENOIT-WILSON, MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:BENOIT-WILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 FALLS OF NEUSE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8496
Mailing Address - Country:US
Mailing Address - Phone:919-350-1380
Mailing Address - Fax:919-556-0124
Practice Address - Street 1:10010 FALLS OF NEUSE RD STE 205
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8496
Practice Address - Country:US
Practice Address - Phone:919-350-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA076141207V00000X
PAMD417391207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1861205OtherHIGHMARK BLUE SHIELD
PA1552444OtherGATEWAY-WMG
PA184482OtherUNISON-WMG
PA20053954OtherAMERIHEALTH MERCY-WMG
PA2145007OtherMAMSI-WMG
PA7288533OtherAETNA
MD883824OtherMARYLAND BLUE SHIELD
PA101467OtherGEISINGER
PA101602749Medicaid
PA203248OtherJOHNS HOPKINS
PA50059228OtherCAPITAL BLUE CROSS-WMG
PA101467OtherGEISINGER
PA50059228OtherCAPITAL BLUE CROSS-WMG
MD883824OtherMARYLAND BLUE SHIELD
PA2145007OtherMAMSI-WMG