Provider Demographics
NPI:1669453007
Name:BENDER, ELIZABETH A (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:BENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:168 E MARKET ST
Mailing Address - Street 2:PO BOX 3542
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-2038
Mailing Address - Country:US
Mailing Address - Phone:330-996-0347
Mailing Address - Fax:330-996-0359
Practice Address - Street 1:75 ARCH STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304
Practice Address - Country:US
Practice Address - Phone:330-762-6251
Practice Address - Fax:330-762-1315
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-072377208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2173419Medicaid
G29069Medicare UPIN
OH2173419Medicaid