Doctor Name: | MICHAEL RICHARD BENOIT |
NPI Number: | 1043506785 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | TL-3959 |
Business Practice Address: | 5070 International Blvd Suite 131 North Charleston, SC - 294186006 |
Business Phone Number: | 8437637906 |
Business Fax Number: | 8437409039 |
Mailing Address: | Po Box 751649, CHARLOTTE |
State: | NC |
Postal Code: | 282751649 |
Phone Number: | 8437891620 |
Fax Number: | 8437242440 |
NPI Enumeration Date: | 06/21/2011 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | TL-3959 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |