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Individual

MR. SAMUEL EDISON BENTON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, CRNA

Contact information

Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 668-0289
Mailing address
PO BOX 3094, DURHAM, NC 27715-3094

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
118950
NC

Other

Enumeration date
09/12/2019
Last updated
09/12/2019
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