Individual
BENJAMIN P BLAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
3621 RANDOLPH RD STE 100, CHARLOTTE, NC 28211-0027
(704) 512-3303
Mailing address
813 SAVILE LN, FORT MILL, SC 29715-7800
(704) 564-5161
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
29069
SC
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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