Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | H117701 | IA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | R225313 | MD |
N | 363LG0600X | Nurse Practitioner - Gerontology | H117701 | IA |
N | 363LP2300X | Nurse Practitioner - Primary Care | H117701 | IA |
NPI | 1073914404 |
---|---|
Provider Name | Dr. Meredith Elyse Benjamin |
First Address | Baltimore, MD 21201-5633 |
Second Address | Baltimore, MD 21201-5633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2014 |
Last Update Date | 04/01/2017 |