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Individual

BENJAMIN JACOB PAULIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
8 RICHLAND MEDICAL PARK DR STE 400, COLUMBIA, SC 29203-8004
(803) 765-9215
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MPA.2759
SC
363AS0400X
Surgical Physician Assistant
2759
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3035PA
SC
Enumeration date
06/21/2017
Last updated
01/15/2024
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