Healthcare Provider Details

I. General information

NPI: 1952161234
Provider Name (Legal Business Name): BENJAMIN ANTONIO OBANDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HENDERSONVILLE RD
ASHEVILLE NC
28803-2868
US

IV. Provider business mailing address

123 HENDERSONVILLE RD
ASHEVILLE NC
28803-2868
US

V. Phone/Fax

Practice location:
  • Phone: 828-407-2415
  • Fax: 828-412-4171
Mailing address:
  • Phone: 828-407-2415
  • Fax: 828-412-4171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: