Individual
MARK E BENESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
52300
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240471
COVENTRY FOR CCH
NE
01
—
38702
BCBS NE FOR CCH
NE
01
—
4319
MIDLANDS CHOICE FOR CCH
NE
05
—
47055169400
—
NE
Enumeration date
06/01/2005
Last updated
01/11/2021
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