Provider Demographics
NPI:1518386556
Name:SIMSON, BENJAMIN E (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:E
Last Name:SIMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7615 ORA GLEN DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3642
Mailing Address - Country:US
Mailing Address - Phone:240-624-2323
Mailing Address - Fax:855-540-2225
Practice Address - Street 1:7474 GREENWAY CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3592
Practice Address - Country:US
Practice Address - Phone:240-624-2278
Practice Address - Fax:240-624-2279
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD85060208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1518386556Medicaid