Individual
BENJAMIN DAVID THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-7025
(864) 560-7388
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41006
SC
Other
Enumeration date
04/25/2017
Last updated
01/04/2021
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