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General NPI Number Information
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NPI Number | 1083969802
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Entity Type | Individual
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Provider Name | CARLA GRACE NICOLE BENJAMIN M.D
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 2451 UNIVERSITY HOSPITAL DRIVE, MASTIN 102
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City | MOBILE
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State | AL
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Zip | 36617-2300
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Country | US
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Telephone | 251-470-5890
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Fax | 251-471-7925
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Provider Business Mailing Address
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Address Line | PO BOX 746450
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City | ATLANTA
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State | GA
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Zip | 30374-6450
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Country | US
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Telephone | 866-401-3057
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Fax | 318-868-6430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 39956
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD.49251
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 39956
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License Number State | KS
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