Individual
DR. SCOTT EVAN BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
42-0010625
VT
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
84390
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02502692
—
NY
05
—
1009844
—
VT
Enumeration date
09/27/2006
Last updated
10/23/2020
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