Individual
BENJAMIN JEFFREY ROBERT CHILDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2024-00844
NC
2085R0204X
Vascular & Interventional Radiology Physician
2024-00844
NC
390200000X
Student in an Organized Health Care Education/Training Program
0116037656
VA
Other
Enumeration date
06/11/2018
Last updated
08/27/2024
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