Provider Demographics
NPI:1538621404
Name:BENN, RUBY ATTAH (MD)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:ATTAH
Last Name:BENN
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 1:13620 REESE BLVD E STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6418
Mailing Address - Country:US
Mailing Address - Phone:929-383-2867
Mailing Address - Fax:
Practice Address - Street 1:13620 REESE BLVD E STE 100
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6418
Practice Address - Country:US
Practice Address - Phone:704-801-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-01511207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty