Provider Demographics
NPI:1457771826
Name:GANS, BENJAMIN
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:GANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-8816
Mailing Address - Country:US
Mailing Address - Phone:828-538-4546
Mailing Address - Fax:
Practice Address - Street 1:80 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713-8816
Practice Address - Country:US
Practice Address - Phone:828-538-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine