Healthcare Provider Details

I. General information

NPI: 1659546976
Provider Name (Legal Business Name): DR. DINESH BENJAMIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 07/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 BROAD ST
DURHAM NC
27705-4833
US

IV. Provider business mailing address

PO BOX 1630
PINEHURST NC
28370-1630
US

V. Phone/Fax

Practice location:
  • Phone: 919-972-7700
  • Fax:
Mailing address:
  • Phone: 910-295-6007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2010-01685
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: