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Individual
BENJAMIN MARTIN PETTY
Active
Individual
BENJAMIN MARTIN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2017-00201
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2017-00201
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017-00201
NC MEDICAL LICENSE
NC
Enumeration date
06/13/2011
Last updated
04/28/2022
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