Dr. Benedict A Profera
Primary Podiatric Medicine
1589 Innsbrooke Dr
Salem
, Virginia 24153-1785
Dr. Benedict A Profera
Primary Podiatric Medicine
1589 Innsbrooke Dr
Salem
, Virginia 24153-1785
(540) 389-6267
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About
Features
Specialties
- Primary Podiatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Benedict A Profera
- 1589 Innsbrooke Dr
- Salem, VA
- Zip : 24153-1785
- Phone : (540) 389-6267
Second Address
- Dr. Benedict A Profera
- 1589 Innsbrooke Dr
- Salem, VA
- Zip : 24153-1785
- Phone : (540) 389-6267
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | 0103000566 | VA |
National Provider Identifier
| NPI | 1356497622 |
|---|---|
| Provider Name | Dr. Benedict A Profera |
| First Address | Salem, VA 24153-1785 |
| Second Address | Salem, VA 24153-1785 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 010265851 | (05) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.