Individual
MARK PALMER BENSON
Active
Individual
MARK PALMER BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M3650
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000100001648
BLUE SHIELD
ID
05
—
002440600
—
ID
05
—
003608500
—
ID
01
—
110042845
RR MEDICARE
ID
01
—
29296
BLUE SHIELD GROUP NUMBER
ID
01
—
36509
BLUE CROSS
ID
01
—
88765
BLUE CROSS GROUP NUMBER
ID
01
—
CP9190
RAILROAD MEDICARE GRP #
ID
Enumeration date
11/29/2006
Last updated
11/10/2011
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