Individual
BENJAMIN K MCINNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2687 LAKE PARK DR, N CHARLESTON, SC 29406-9100
(843) 572-0097
Mailing address
2687 LAKE PARK DR, N CHARLESTON, SC 29406-9100
(843) 572-0097
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
8100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081002
—
SC
01
—
1942242714
GROUP NPI
SC
Enumeration date
03/28/2006
Last updated
05/23/2012
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