Provider Demographics
NPI:1942246319
Name:BENSIMHON, PAMELA F (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:F
Last Name:BENSIMHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 HAZEL LN
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3188
Mailing Address - Country:US
Mailing Address - Phone:336-638-6111
Mailing Address - Fax:
Practice Address - Street 1:1150 REVOLUTION MILL DR STE 11
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5086
Practice Address - Country:US
Practice Address - Phone:336-763-2344
Practice Address - Fax:336-790-9752
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901515208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10383978Medicaid
WV3810007247Medicaid
189347OtherMEDCOST
7523810OtherAETNA
142JXOtherBCBS
808932OtherPARTNERS
NC5904844Medicaid
NC5904844Medicaid