Provider Demographics
NPI:1447921275
Name:POTEAT, BENJAMIN ANDREW (NP)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ANDREW
Last Name:POTEAT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-4972
Mailing Address - Country:US
Mailing Address - Phone:828-580-1750
Mailing Address - Fax:828-580-1751
Practice Address - Street 1:20 S MEDICAL CT
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-4972
Practice Address - Country:US
Practice Address - Phone:828-580-1750
Practice Address - Fax:828-580-1751
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily