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NPI Code Detail

MEDICARE: VERED BUTBUL BENEZRA FNP

MEDICARE: VERED BUTBUL BENEZRA FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner22964SC

General Provider Information

NPI Number : 1528611605
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERED BUTBUL BENEZRA FNP
Provider Business Mailing Address
First Line : PO BOX 421718
Second Line :
City : GEORGETOWN
State : SC
Zip : 29442-4203
Country : US
Telephone Number : 843-527-7000
Fax Number :
Provider Business Practice Location Address
First Line : 2347 S HIGHWAY 17
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-7611
Country : US
Telephone Number : 843-357-2443
Fax Number : 843-357-2132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2019
Last Update Date : 11/07/2025

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Directions to “ VERED BUTBUL BENEZRA FNP” Practice Location

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