# ERIC SAMUEL BENJAMIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275163529
- **Gender:** Man
- **Credential:** PA - C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 0110007765 | VA | — |
| 363A00000X | Physician Assistant | 12238 | GA | Yes |
| 363A00000X | Physician Assistant | PA2228 | NV | — |

## Other

- **Enumeration date:** 01/24/2020
- **Last updated:** 02/18/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0110007765 | STATE LICENSE | VA |
| 05 | — | 1275163529 | — | NV |
| 01 | — | PA2228 | STATE LICENSE | NV |