Provider Demographics
NPI:1558332684
Name:BENOIT-WILSON, MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:BENOIT-WILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-0351
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:10010 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8494
Practice Address - Country:US
Practice Address - Phone:919-350-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417391207V00000X
NJMA076141207V00000X
NC2015-00121207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101467OtherGEISINGER
PA20053954OtherAMERIHEALTH MERCY-WMG
NC1558332684Medicaid
PA1552444OtherGATEWAY-WMG
PA184482OtherUNISON-WMG
PA203248OtherJOHNS HOPKINS
PA7288533OtherAETNA
PA50059228OtherCAPITAL BLUE CROSS-WMG
PA101602749Medicaid
PA1861205OtherHIGHMARK BLUE SHIELD
PA2145007OtherMAMSI-WMG
MD883824OtherMARYLAND BLUE SHIELD
PA50059228OtherCAPITAL BLUE CROSS-WMG
MD883824OtherMARYLAND BLUE SHIELD
PA2145007OtherMAMSI-WMG