Individual
MR. BENJAMIN WILLIAMS DIFFENDERFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
510 UPPER CHESAPEAKE DR., SUITE 417, PHYSICIANS PAVILLION II, BEL AIR, MD 21014
(443) 643-3130
(443) 643-3155
Mailing address
510 UPPER CHESAPEAKE DR., SUITE 417, PHYSICIANS PAVILLION II, BEL AIR, MD 21014
(443) 643-3130
(443) 643-3155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0004567
MD
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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