Healthcare Provider Details

I. General information

NPI: 1922000678
Provider Name (Legal Business Name): BENJAMIN D ESKRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WAYNE MEMORIAL DR SUITE B
GOLDSBORO NC
27534-1789
US

IV. Provider business mailing address

PO BOX 250
BEAVER PA
15009-0250
US

V. Phone/Fax

Practice location:
  • Phone: 919-587-4400
  • Fax: 919-587-4411
Mailing address:
  • Phone: 800-634-0201
  • Fax: 866-727-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number2009-00677
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: