Individual
DR. JEROME BENITEZ AYA-AY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8311 WARREN H ABERNATHY HWY, SPARTANBURG, SC 29301-1249
(864) 562-5100
(864) 562-5230
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27210
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272109
—
SC
Enumeration date
08/25/2006
Last updated
11/05/2009
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