Individual
DR. MARK BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9501 ROOSEVELT BLVD, SUITE #208, PHILADELPHIA, PA 19114-1025
(215) 969-2300
(215) 969-2327
Mailing address
9501 ROOSEVELT BLVD, SUITE #208, PHILADELPHIA, PA 19114-1025
(215) 969-2300
(215) 969-2327
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD026817E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065803
—
PA
05
—
0907010
—
PA
Enumeration date
04/19/2006
Last updated
07/08/2007
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