Provider Demographics
NPI:1861431280
Name:BENTMAN, STEVEN M (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:BENTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CODY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1375
Mailing Address - Country:US
Mailing Address - Phone:410-256-7015
Mailing Address - Fax:410-256-7015
Practice Address - Street 1:4924 CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-5908
Practice Address - Country:US
Practice Address - Phone:443-461-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD36487207P00000X
MDD0036487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD413046400Medicaid
MD60050001OtherDC BLUE CROSS
MD20012629OtherAMERIHEALTH MERCY HEALTH
MD60059303OtherBLUE CROSS
MD930110637OtherRAILROAD MEDICARE
MD531571900Medicaid
MDP00430526OtherRAILROAD
MDP00430526OtherRAILROAD
MDB68384Medicare UPIN