Provider Demographics
NPI:1306378542
Name:BENJAMIN, BRITTANY MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E CHEVES ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2647
Mailing Address - Country:US
Mailing Address - Phone:843-777-5064
Mailing Address - Fax:843-777-7762
Practice Address - Street 1:204 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2647
Practice Address - Country:US
Practice Address - Phone:843-777-5064
Practice Address - Fax:843-777-7762
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC84988208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics