Individual
BENJAMIN STEVAN VANTASEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
600 GRESHAM DR STE 100, NORFOLK, VA 23507-1904
(757) 388-6200
Mailing address
103 E MEADOWLARK ST, KILL DEVIL HILLS, NC 27948-9174
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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