Provider Demographics
NPI:1356575864
Name:BENEDICT, CAROL DEANE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL DEANE
Middle Name:
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROL DEANE
Other - Middle Name:BENEDICT
Other - Last Name:MITNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3800 RESERVOID RD. NW SUITE 3004
Mailing Address - Street 2:PHC 3RD FLOOR, DIV. OF RHEUM, GEORGETOWN UNIVERSITY HOS
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:22102
Mailing Address - Country:US
Mailing Address - Phone:202-444-6200
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW SUITE 3004
Practice Address - Street 2:PHC 3RD FLOOR, DIV. OF RHEUM, GEORGETOWN UNIVERSITY HOS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD040698207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program