Wayne Douglas Benjamin, MD
Individual provider Active NPI Family Medicine Physician · Chestertown, MD
NPI 1992761472 · NPPES record last updated Jun 13, 2011
Key facts
- NPI
- 1992761472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- D16488 (MD)
- Practice address
- 6602 Church Hill Rd
200
Chestertown, MD 21620 - Phone
- (410) 778-0300
- Fax
- (410) 778-0351
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidney Health Center of Maryland P.a. | Past |
Accepting new patients | |
| Chestertown Family Medicine PA | Family Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D16488 | MD | Yes |
Addresses
Primary practice location
6602 Church Hill Rd
200
Chestertown, MD 21620
Mailing address
6602 Church Hill Rd
200
Chestertown, MD 21620
Phone (410) 778-0300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033141400 | Medicaid | MD |
Other providers in Chestertown, MD
- Beatrice Anne Bautista
- Bay River Primary Care PC
- Kaitlin Marie Beck
- Jordan B. Bell
- Suzanne C Benjamin
- Alaka Bhatt-Patel
- Lynn Kathleen Bickley
- Bruce M. Blackburn
- Joanna M. Blackburn
- Sean Blackwell
All providers in Chestertown, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.