MEDICARE: DR. ANA BENITEZ-GRAHAM M.D.

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
1	207N00000X	Dermatology Physician	2006-01011	NC

General Provider Information

NPI Number	:	1619197845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA BENITEZ-GRAHAM M.D.

Provider Business Mailing Address
First Line	:	3940 ARROWHEAD BLVD STE 210
Second Line	:
City	:	MEBANE
State	:	NC
Zip	:	27302-7637
Country	:	US
Telephone Number	:	919-304-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3940 ARROWHEAD BLVD STE 210
Second Line	:
City	:	MEBANE
State	:	NC
Zip	:	27302-7637
Country	:	US
Telephone Number	:	919-304-5900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2007
Last Update Date	:	10/01/2012

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