Provider Demographics
NPI:1790919827
Name:BENAVENTE, CHRISTOPHER JORDAN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JORDAN
Last Name:BENAVENTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:128 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-1358
Practice Address - Country:US
Practice Address - Phone:419-898-0462
Practice Address - Fax:419-898-9148
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34011023207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology