Individual
DR. BENJAMIN DERRICK INGRAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4406-A FOREST DRIVE, SUITE 1, COLUMBIA, SC 29206
(803) 782-7080
(803) 744-0964
Mailing address
4406 - A FOREST DRIVE, SUITE 1, COLUMBIA, SC 29206
(803) 782-7080
(803) 744-0964
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1320
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D13206
—
SC
Enumeration date
03/24/2006
Last updated
07/08/2007
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