Individual
DEBORAH BENEVENUTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1525 N 12TH ST, MILWAUKEE, WI 53205-2591
(414) 966-3030
Mailing address
8701 W WATERTOWN PLANK RD, MILWAUKEE, WI 53226-3548
(414) 955-8998
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
74599-20
WI
208D00000X
General Practice Physician
74599-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100149489
—
WI
Enumeration date
05/28/2019
Last updated
04/07/2025
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