Individual
BENJAMIN CALEB WEATHERSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2728 SUNSET BLVD STE 300, WEST COLUMBIA, SC 29169-4815
(803) 744-4940
(803) 744-4938
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
21341
SC
Other
Enumeration date
10/02/2017
Last updated
11/11/2020
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