Provider Demographics
NPI:1558542332
Name:BENSI, DEBORA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:ELENA
Last Name:BENSI
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:PO BOX 18
Mailing Address - Street 2:4061 OLD PESHTIGO RD
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3887
Mailing Address - Country:US
Mailing Address - Phone:715-732-8000
Mailing Address - Fax:715-732-8131
Practice Address - Street 1:4061 OLD PESHTIGO RD
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3887
Practice Address - Country:US
Practice Address - Phone:715-732-8000
Practice Address - Fax:715-732-8131
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT191769207Q00000X
WI54760-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI401200236Medicare PIN