# CROSSROADS MEDICAL GROUP, P.A.

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

## Provider details

- **NPI number:** 1720041890
- **Authorized official:** DR. SAMUEL I BENESH M.D. (PRESIDENT)
- **Authorized official phone:** (410) 998-9955

## Contact information

- **Practice address:** 2700 QUARRY LAKE DRIVE, SUITE 350, BALITMORE, MD 21209-0000
- **Practice address phone:** (410) 998-9955
- **Practice address fax:** (410) 998-9961
- **Mailing address:** 2700 QUARRY LAKE DRIVE, SUITE 350, BALTIMORE, MD 21209-0000
- **Mailing address phone:** (410) 998-9955
- **Mailing address fax:** (410) 998-9961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | MD | Yes |

## Other

- **Enumeration date:** 04/10/2006
- **Last updated:** 01/07/2011