Provider Demographics
NPI:1619197845
Name:BENITEZ-GRAHAM, ANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:BENITEZ-GRAHAM
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 1:3940 ARROWHEAD BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7637
Mailing Address - Country:US
Mailing Address - Phone:919-304-5900
Mailing Address - Fax:
Practice Address - Street 1:3940 ARROWHEAD BLVD STE 210
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7637
Practice Address - Country:US
Practice Address - Phone:919-304-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01011207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology