Individual
GREGORY ALLEN BENBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
(540) 932-4000
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 932-5162
(540) 932-5875
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102037018
VA
207Q00000X
Family Medicine Physician
0102037018
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005880351
—
VA
05
—
1760454078
—
VA
01
—
236392
BLUE SHIELD
VA
05
—
3810015628
—
WV
Enumeration date
02/02/2006
Last updated
06/10/2020
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