Provider Demographics
NPI:1629297411
Name:ROHENA, CARLA DIBENEDETTO (PA)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:DIBENEDETTO
Last Name:ROHENA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7346
Mailing Address - Country:US
Mailing Address - Phone:910-251-9944
Mailing Address - Fax:
Practice Address - Street 1:1099 MEDICAL CENTER DR STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7346
Practice Address - Country:US
Practice Address - Phone:910-251-9944
Practice Address - Fax:910-763-4666
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103661363A00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1629297411OtherNPI