Individual
LEROY DEHAVEN BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
203 N PAGE ST, CHESTERFIELD, SC 29709-1201
(843) 260-9573
Mailing address
203 N PAGE ST, CHESTERFIELD, SC 29709-1201
(843) 260-9573
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
69149
SC
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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