Individual
PHILIP DAVID BENETATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605-4210
(864) 455-7899
(864) 455-5474
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20969
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4563
—
SC
Enumeration date
03/30/2017
Last updated
07/24/2024
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