Provider Demographics
NPI:1578585683
Name:PHILOSOPHE, BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:PHILOSOPHE
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:PO BOX 64563
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4563
Mailing Address - Country:US
Mailing Address - Phone:410-614-2989
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-614-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAD53061208600000X
MDD53061204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000870601Medicaid
MD0006OtherCAREFIRST REGIONAL
PA1783285/01Medicaid
MD413010300Medicaid
MD1700812OtherUNITED HLTHCARE
MD262397OtherMDIPA
MD65481OtherGEISINGER
MD214338OtherKAISER
NJ8798800Medicaid
MD1853058OtherUNITED HLTHCARE NATIONAL
MD54827302OtherBLUE SHIELD
MD1700812OtherUNITED HLTHCARE
MD413010300Medicaid
MD65481OtherGEISINGER