Individual
BENJAMIN L ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4220
(984) 974-1000
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200300440
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
200300440
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10202191
—
VA
01
—
140P7
BCBS
—
01
—
182870
MEDCOST
—
05
—
3810003225
—
WV
05
—
5901916
—
NC
01
—
7356804
AETNA
—
01
—
806746
PARTNERS
—
01
—
P00662391
RAILROAD-MEDICARE
NC
05
—
Q0044G
—
SC
Enumeration date
12/13/2005
Last updated
10/04/2021
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