Petty, Benjamin Martin

Petty, Benjamin Martin is an individual health care provider with primary practice located at 120 William Penn Plz , Durham NC 27704-2150. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Petty, Benjamin Martin can be contacted via phone (919) 220-5255.

Contact Information

Primary practice address
120 William Penn Plz Durham NC 27704-2150
Phone: (919) 220-5255
Fax: (919) 313-1276
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2017-00201 North Carolina
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 2017-00201 North Carolina

Profile Details

NPI number 1518252105
LBN Legal business name Petty, Benjamin Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2011
Last updated Apr 28th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518252105 NPPES
North Carolina Other 2017-00201 NC MEDICAL LICENSE

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