Provider Demographics
NPI:1902245830
Name:CHAON, BENJAMIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:C
Last Name:CHAON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 N. WOLFE STREET
Mailing Address - Street 2:MAUMENEE 3
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287
Mailing Address - Country:US
Mailing Address - Phone:410-955-2966
Mailing Address - Fax:410-955-2924
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:MAUMENEE 3
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-955-2966
Practice Address - Fax:410-955-2924
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0085758207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty