Individual
BENJAMIN JAMES MUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
125 QUEENS RD STE 250, CHARLOTTE, NC 28204-3419
(704) 316-5100
(704) 316-5101
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-15330
NC
363AM0700X
Medical Physician Assistant
005065
CT
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
04/06/2020
Last updated
05/06/2026
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