Provider Demographics
NPI:1568420818
Name:BENSON, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:BENSON
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 1:910 E WILLOW GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7910
Mailing Address - Country:US
Mailing Address - Phone:215-233-4300
Mailing Address - Fax:215-836-1991
Practice Address - Street 1:910 E WILLOW GROVE AVE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7910
Practice Address - Country:US
Practice Address - Phone:215-233-4300
Practice Address - Fax:215-836-1991
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016487E207W00000X
NJ25MA04028100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006620330001Medicaid
PA160773Medicare ID - Type UnspecifiedPA MEDICARE
C32347Medicare UPIN
PA0006620330001Medicaid