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Individual

DR. BENEDICT A PROFERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM, MPH

Contact information

Practice address
1589 INNSBROOKE DR, SALEM, VA 24153-1785
(540) 389-6267
Mailing address
1589 INNSBROOKE DR, SALEM, VA 24153-1785
(540) 389-6267

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0103000566
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010265851
VA
Enumeration date
01/26/2007
Last updated
07/08/2007
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