Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 22226 | SC |
NPI | 1265488191 |
---|---|
Provider Name | Ashley Beasley Benson |
First Address | Atlanta, GA 30374-3070 |
Second Address | Spartanburg, SC 29307-1726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 25/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
222262 | (05) | SC |
H56036 | (02) | SC |