Provider Demographics
NPI:1932383775
Name:BENSON, STEPHANIE MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:BENSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6040 UNIVERSITY TOWN CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-2421
Mailing Address - Country:US
Mailing Address - Phone:304-598-4000
Mailing Address - Fax:304-285-7373
Practice Address - Street 1:9849 KENWORTHY ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4402
Practice Address - Country:US
Practice Address - Phone:921-215-5500
Practice Address - Fax:915-215-8655
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2024-11-20
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Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0508207Q00000X
WV22450207Q00000X
TXV4642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine