Provider Demographics
NPI:1902845076
Name:BENEDICT, WILLIAM W (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:BENEDICT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:226 S WOODS MILL RD
Mailing Address - Street 2:SUITE 56W
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3662
Mailing Address - Country:US
Mailing Address - Phone:314-373-2501
Mailing Address - Fax:314-373-2508
Practice Address - Street 1:226 S WOODS MILL RD
Practice Address - Street 2:SUITE 56W
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-373-2501
Practice Address - Fax:314-373-2508
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR6999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA13223Medicare UPIN