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Individual

ANDREW ROBERT BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
600 N WOLFE ST, BLALOCK 1415, BALTIMORE, MD 21287-0005
(410) 955-8408
Mailing address
506 CREEK CROSSING LN, GLEN BURNIE, MD 21060-7515
(410) 935-8440

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R162397
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
R162397
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
417823800
MD
Enumeration date
04/06/2009
Last updated
10/29/2009
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