Individual
MICHAEL BENUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
226 WOODLAND DR, RAEFORD, NC 28376-5410
(910) 853-1290
Mailing address
226 WOODLAND DR, RAEFORD, NC 28376
(910) 853-1290
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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