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General NPI Number Information
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NPI Number | 1770554503
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Entity Type | Individual
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Provider Name | BENJAMIN ELLISON PUSSER DO
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 250 POTATO BRANCH RD
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City | LEICESTER
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State | NC
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Zip | 28748-6606
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Country | US
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Telephone | 828-378-0060
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Fax | 828-355-5642
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Provider Business Mailing Address
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Address Line | PO BOX 1974
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City | ASHEVILLE
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State | NC
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Zip | 28802-1974
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Country | US
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Telephone | 828-378-0060
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Fax | 828-355-5642
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200400401
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License Number State | NC
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