Individual
BENI MFITIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 VILLAGE HARBOR DR, LAKE WYLIE, SC 29710-9092
(803) 631-2858
Mailing address
1200 VILLAGE HARBOR DR, LAKE WYLIE, SC 29710-9092
(803) 631-2858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
90556
SC
Other
Enumeration date
03/26/2020
Last updated
07/28/2023
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