Provider Demographics
NPI:1356419246
Name:WITHERS, BENJAMIN GUY (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:GUY
Last Name:WITHERS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8616 W BOULEVARD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-2031
Mailing Address - Country:US
Mailing Address - Phone:703-799-1311
Mailing Address - Fax:703-806-3591
Practice Address - Street 1:9501 FARRELL RD
Practice Address - Street 2:DEWITT HEALTH CARE NETWORK
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5901
Practice Address - Country:US
Practice Address - Phone:703-806-4586
Practice Address - Fax:703-806-3591
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010521722083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine