Provider Demographics
NPI:1164690483
Name:DURHAM, BENJAMIN HEATH (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:HEATH
Last Name:DURHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SOMERSET ST APT 2008
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-4810
Mailing Address - Country:US
Mailing Address - Phone:256-574-9779
Mailing Address - Fax:
Practice Address - Street 1:195 LITTLE ALBANY ST RM 4557
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11324200207ZH0000X, 207ZP0007X, 207ZP0102X
NY270378207ZH0000X, 207ZP0007X, 207ZP0102X
CA120870207ZH0000X, 207ZP0007X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology