Provider Demographics
NPI:1952362204
Name:STRAG, BENJAMIN (PA)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:STRAG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:STE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:306 WESTWOOD AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4341
Practice Address - Country:US
Practice Address - Phone:336-885-6168
Practice Address - Fax:336-885-8523
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC102888363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00654541OtherRR MEDICARE
NC2752876DMedicare PIN
NCP00654541OtherRR MEDICARE
NC2752876AMedicare ID - Type Unspecified