Provider Demographics
NPI:1982941423
Name:BENIGN DIAGNOSTICS
Entity type:Organization
Organization Name:BENIGN DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VAIDEHI
Authorized Official - Middle Name:
Authorized Official - Last Name:KANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-787-1218
Mailing Address - Street 1:15807 CHAGALL TER
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3461
Mailing Address - Country:US
Mailing Address - Phone:301-787-1216
Mailing Address - Fax:
Practice Address - Street 1:7858 BEECHCRAFT AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-1542
Practice Address - Country:US
Practice Address - Phone:301-787-1216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1832291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory