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1952378846

NPI Code Detail

MEDICARE: DR. JOHN DEWITT BENSON MD

MEDICARE: DR. JOHN DEWITT BENSON MD

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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	23829	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14984	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952378846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DEWITT BENSON MD

Provider Business Mailing Address
First Line	:	PO BOX 100559
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29501-0559
Country	:	US
Telephone Number	:	843-664-4300
Fax Number	:	843-664-4308

Provider Business Practice Location Address
First Line	:	4440 LAKE BOONE TRL
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-7505
Country	:	US
Telephone Number	:	919-784-3100
Fax Number	:	919-784-3362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	04/17/2008

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Directions to “ DR. JOHN DEWITT BENSON MD” Practice Location

Language	Start Address	Practice Location

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