Provider Demographics
NPI:1609975663
Name:JAMES J BENJAMIN MD PA
Entity Type:Organization
Organization Name:JAMES J BENJAMIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-768-7755
Mailing Address - Street 1:PO BOX 1405
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21105
Mailing Address - Country:US
Mailing Address - Phone:410-768-7755
Mailing Address - Fax:410-768-8434
Practice Address - Street 1:8109 RITCHIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:PASADINA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:410-768-7755
Practice Address - Fax:410-768-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD8387207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0457755OtherAETNA
MD2050OtherCFBCBS
MD2050OtherCFBCBS
D76855Medicare UPIN