Provider Demographics
NPI:1376920223
Name:RICE, BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:RICE
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 1:600 RAVENSCROFT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23805-7125
Mailing Address - Country:US
Mailing Address - Phone:804-733-8491
Mailing Address - Fax:
Practice Address - Street 1:600 RAVENSCROFT RD
Practice Address - Street 2:
Practice Address - City:SOUTH PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23805-7125
Practice Address - Country:US
Practice Address - Phone:804-733-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101015998174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator