Provider Demographics
NPI:1730989682
Name:WELBON, BENITA M
Entity type:Individual
Prefix:
First Name:BENITA
Middle Name:M
Last Name:WELBON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E REDWOOD ST STE 500A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-6292
Mailing Address - Country:US
Mailing Address - Phone:240-217-7212
Mailing Address - Fax:
Practice Address - Street 1:233 E REDWOOD ST STE 500A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-6292
Practice Address - Country:US
Practice Address - Phone:240-217-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty