Provider Demographics
NPI:1669420246
Name:VANLANDINGHAM, BENJAMIN DWIGHT (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DWIGHT
Last Name:VANLANDINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:809 GLENEAGLES CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2202
Mailing Address - Country:US
Mailing Address - Phone:410-821-7471
Mailing Address - Fax:410-821-9582
Practice Address - Street 1:SAINT JOSEPH MEDICAL CENTER
Practice Address - Street 2:7601 OSLER DRIVE
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-337-1226
Practice Address - Fax:410-337-1118
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0060005207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402213100Medicaid
MDH822H094Medicare ID - Type Unspecified
MD402213100Medicaid