Provider Demographics
NPI:1982676789
Name:BENEDICT, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BENEDICT
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 1:5433 STATE ROUTE 113
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-9708
Mailing Address - Country:US
Mailing Address - Phone:419-483-2403
Mailing Address - Fax:419-483-8418
Practice Address - Street 1:5433 STATE ROUTE 113
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-9708
Practice Address - Country:US
Practice Address - Phone:419-483-2403
Practice Address - Fax:419-483-8418
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350750122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11211354OtherCAQH
OH249285OtherANTHEM INS
OHP00062349OtherRAILROAD MEDICARE
OH2176685Medicaid
OH04235OtherPARAMOUNT
OH7992074OtherAETNA INS
OH11211354OtherCAQH
OH4091631Medicare PIN