Provider Demographics
NPI:1699429092
Name:BEN-OR, ISAAC (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:BEN-OR
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 DELIGHT MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-6219
Mailing Address - Country:US
Mailing Address - Phone:410-960-2399
Mailing Address - Fax:443-501-3953
Practice Address - Street 1:215 DELIGHT MEADOWS RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-6219
Practice Address - Country:US
Practice Address - Phone:410-960-2399
Practice Address - Fax:443-501-3953
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045324207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0045324OtherMEDICAL LICENSE NUMBER