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Individual

DR. NATHANAEL RICARDO BENITEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
106 PARKVIEW DR, LAURENS, SC 29360-2652
(864) 984-0571
(864) 984-3610
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37627
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
376276
SC
Enumeration date
06/21/2015
Last updated
06/30/2021
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