Provider Demographics
NPI:1386624260
Name:CARL S BENDER MD PC
Entity type:Organization
Organization Name:CARL S BENDER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-635-9400
Mailing Address - Street 1:1 ACTON PLACE
Mailing Address - Street 2:STE 102
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720
Mailing Address - Country:US
Mailing Address - Phone:978-635-9400
Mailing Address - Fax:978-635-3924
Practice Address - Street 1:1 ACTON PLACE
Practice Address - Street 2:STE 102
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720
Practice Address - Country:US
Practice Address - Phone:978-635-9400
Practice Address - Fax:978-635-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
M13838Medicare ID - Type Unspecified
B14088Medicare UPIN