Provider Demographics
NPI:1740515162
Name:POWERS, BENJAMIN DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DANIEL
Last Name:POWERS
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 64226
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4226
Mailing Address - Country:US
Mailing Address - Phone:667-214-1734
Mailing Address - Fax:410-706-6976
Practice Address - Street 1:901 HARRY TRUMAN DR N
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5477
Practice Address - Country:US
Practice Address - Phone:667-214-1718
Practice Address - Fax:410-706-6976
Is Sole Proprietor?:No
Enumeration Date:2009-10-03
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195970208600000X
FLME128282208600000X
MD2V229522086X0206X
MD2V29732086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMT195970OtherPA STATE LICENSE NUMBER
FLME128282OtherFLORIDA BOARD OF MEDICINE LICENSE