| Organization Name: | WAYNE D BENJAMIN MD PA |
| NPI Number: | 1306105796 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WAYNE D BENJAMIN (OWNER) |
| Mailing Address: | 6602 Church Hill Rd Suite 250 Chestertown |
| State: | MD US |
| Postal Code: | 216202310 |
| Phone Number: | 4107083994 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2012 |
| NPI Last Update Date: | 05/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |