Provider Demographics
NPI:1295393395
Name:CANIPE, BENJAMIN T (DO)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:T
Last Name:CANIPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FLUGPLATZ ERBENHEIM 1040
Mailing Address - Street 2:
Mailing Address - City:WIESBADEN
Mailing Address - State:GERMANY
Mailing Address - Zip Code:65205
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:FLUGPLATZ ERBENHEIM 1040
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:65205
Practice Address - Country:US
Practice Address - Phone:304-315-2057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2021-00792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program