Individual
DR. DEREK ALAN BENHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101263734
VA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2025025054
MO
208600000X
Surgery Physician
0101263734
VA
208600000X
Surgery Physician
Primary
2025025054
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200176241
—
MO
Enumeration date
06/29/2016
Last updated
08/11/2026
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