Provider Demographics
NPI:1649823782
Name:CARRION, BENJAMIN MICHAEL (PA-C)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:MICHAEL
Last Name:CARRION
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N GRAHAM HOPEDALE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-2971
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:221 N GRAHAM HOPEDALE RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2971
Practice Address - Country:US
Practice Address - Phone:336-570-3739
Practice Address - Fax:336-570-1215
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-13888363A00000X
NC184182251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary