Provider Demographics
NPI:1811080237
Name:BENSON, MELODY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:ANN
Last Name:BENSON
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 1:11 ELEANOR LEE LN E
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-3150
Mailing Address - Country:US
Mailing Address - Phone:302-381-5046
Mailing Address - Fax:302-212-2472
Practice Address - Street 1:1518 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1624
Practice Address - Country:US
Practice Address - Phone:302-381-8460
Practice Address - Fax:302-212-2472
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00037172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000327801Medicaid
E87880Medicare UPIN
DE0000327801Medicaid