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General NPI Number Information
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NPI Number | 1750322467
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Entity Type | Organization
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Legal Business Name | TWIN ARCH SURGICAL CENTER
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 198 THOMAS JOHNSON DR SUITE 3
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City | FREDERICK
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State | MD
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Zip | 21702-4398
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Country | US
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Telephone | 301-695-9669
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Fax | 301-695-0346
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Provider Business Mailing Address
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Address Line | 1001 TWIN ARCH RD
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City | MOUNT AIRY
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State | MD
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Zip | 21771-4138
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Country | US
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Telephone | 301-829-5111
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Fax | 301-695-0346
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH JAMES BENJAMIN
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Credential |
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Telephone | 301-695-9669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | A1285
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License Number State | MD
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