Individual
DR. DEREK ALAN BENHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(417) 629-7229
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101263734
VA
208600000X
Surgery Physician
Primary
0101263734
VA
Other
Enumeration date
06/29/2016
Last updated
09/15/2024
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