Individual
JEFF A BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8170 ROURK ST, MYRTLE BEACH, SC 29572-4127
(843) 449-2336
(843) 497-2505
Mailing address
8170 ROURK STREET, MYRTLE BEACH, SC 29572-4127
(843) 449-2336
(843) 479-2505
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0501
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005014
—
SC
05
—
01838875
—
PA
01
—
0504464
PHP
SC
01
—
1061000
WORK COMP
WV
01
—
1189849
FIRST HEALTH
SC
01
—
2023740
EVOLUTIONS
SC
01
—
3099820
GHI
SC
01
—
434035
ONE HEALTH PLAN
SC
01
—
521523
FOCUS HEALTHCARE
SC
05
—
6906038
—
NC
01
—
7251177
AETNA
SC
01
—
82645
MEDCOST
SC
01
—
A156
NC UHC
NC
Enumeration date
03/20/2006
Last updated
10/14/2011
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