Provider Demographics
NPI:1275629933
Name:CAMERANSI, BENJAMIN GEORGE JR (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:GEORGE
Last Name:CAMERANSI
Suffix:JR
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:PO BOX 4860
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-2698
Mailing Address - Country:US
Mailing Address - Phone:843-651-2624
Mailing Address - Fax:843-491-4023
Practice Address - Street 1:9180 OCEAN HWY
Practice Address - Street 2:UNIT 6
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-8670
Practice Address - Country:US
Practice Address - Phone:615-824-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC021121207L00000X
SC21121207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89066V6Medicaid
SCP00175713OtherRR MEDICARE
SC211210Medicaid
SCBC6285539OtherDEA
SCP00175713OtherRR MEDICARE
SC211210Medicaid