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Individual
ERIC SAMUEL BENJAMIN
Active
Individual
ERIC SAMUEL BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA - C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110007765
VA
363A00000X
Physician Assistant
Primary
12238
GA
363A00000X
Physician Assistant
PA2228
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110007765
STATE LICENSE
VA
05
—
1275163529
—
NV
01
—
PA2228
STATE LICENSE
NV
Enumeration date
01/24/2020
Last updated
02/18/2025
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