Provider Demographics
NPI:1386718484
Name:BENSENHAVER, DEWEY F (MD)
Entity type:Individual
Prefix:DR
First Name:DEWEY
Middle Name:F
Last Name:BENSENHAVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2888
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:100 HOSPITAL DR STE 1
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-9570
Practice Address - Country:US
Practice Address - Phone:304-257-1944
Practice Address - Fax:304-257-9524
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0052613000Medicaid
A72277Medicare UPIN
WV0052613000Medicaid