Healthcare Provider Details

I. General information

NPI: 1649823782
Provider Name (Legal Business Name): BENJAMIN MICHAEL CARRION PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 09/10/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N GRAHAM HOPEDALE RD
BURLINGTON NC
27217-2971
US

IV. Provider business mailing address

221 N GRAHAM HOPEDALE RD
BURLINGTON NC
27217-2971
US

V. Phone/Fax

Practice location:
  • Phone: 336-570-3739
  • Fax: 336-570-1215
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-13888
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number18418
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: