Individual
BENJAMIN B LORETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 E FREDERICK ST, WALKERSVILLE, MD 21793-8234
(240) 215-6310
Mailing address
400 W 7TH ST, FREDERICK, MD 21701-4506
(240) 215-6310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08982
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055866
MIEMMS
MD
Enumeration date
04/16/2022
Last updated
08/21/2023
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