Provider Demographics
NPI:1194765784
Name:BENEVIDES, MARC D (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:D
Last Name:BENEVIDES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:160 MACGREGOR PINES DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6036
Mailing Address - Country:US
Mailing Address - Phone:919-851-5482
Mailing Address - Fax:919-859-1729
Practice Address - Street 1:160 MACGREGOR PINES DR
Practice Address - Street 2:SUITE 205
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6036
Practice Address - Country:US
Practice Address - Phone:919-851-5482
Practice Address - Fax:919-859-1729
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2010-11-22
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Provider Licenses
StateLicense IDTaxonomies
NC200100014208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH38180Medicare UPIN