Provider Demographics
NPI:1770684821
Name:BENSON, NORBERT WAYNE II (DC)
Entity Type:Individual
Prefix:DR
First Name:NORBERT
Middle Name:WAYNE
Last Name:BENSON
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2107
Mailing Address - Country:US
Mailing Address - Phone:803-667-8332
Mailing Address - Fax:803-667-8332
Practice Address - Street 1:1301 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2107
Practice Address - Country:US
Practice Address - Phone:803-667-8332
Practice Address - Fax:803-667-8332
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010294111N00000X
SC3384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7538368OtherAETNA
NY113490ANOtherPREFERRED CARE
NY9416463OtherPCHS
NYPO1110294OtherBLUE CHOICE
NYPO20111294OtherBLUE CROSS/BLUE SHIELD
NY9416463OtherPCHS
NY113490ANOtherPREFERRED CARE