# BENNER MEDICAL GROUP PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407970809
- **Authorized official:** DR. CHARLES MYRON BENNER MD (PARTNER)
- **Authorized official phone:** (410) 499-6602

## Contact information

- **Practice address:** 14090 HG TRUEMAN RD STE 2300-710, SOLOMONS, MD 20688-3151
- **Practice address phone:** (410) 449-6602
- **Practice address fax:** (410) 499-6605
- **Mailing address:** 14090 HG TRUEMAN RD STE 2300-710, SOLOMONS, MD 20688-3151
- **Mailing address phone:** (410) 449-6602
- **Mailing address fax:** (410) 499-6605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 06/30/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 468851100 | — | MD |
| 05 | — | 468851101 | — | MD |