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NPI Code Detail

MEDICARE: BENJAMIN DENT PIERCE PA-C

MEDICARE: BENJAMIN DENT PIERCE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1184059214
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN DENT PIERCE PA-C
Provider Business Mailing Address
First Line : 107 WEEKS DR
Second Line :
City : ROXBORO
State : NC
Zip : 27573-3929
Country : US
Telephone Number : 336-598-5480
Fax Number :
Provider Business Practice Location Address
First Line : 107 WEEKS DR
Second Line :
City : ROXBORO
State : NC
Zip : 27573-3929
Country : US
Telephone Number : 336-598-5480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2013
Last Update Date : 02/23/2015

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Directions to “ BENJAMIN DENT PIERCE PA-C” Practice Location

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