Profera, Benedict A

Profera, Benedict A is an sole proprietor health care provider with primary practice located at 1589 Innsbrooke Dr , Salem VA 24153-1785. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as his primary health care specialty. Profera, Benedict A can be contacted via phone (540) 389-6267.

Contact Information

Primary practice address
1589 Innsbrooke Dr Salem VA 24153-1785
Phone: (540) 389-6267
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 0103000566 Virginia

Profile Details

NPI number 1356497622
LBN Legal business name Profera, Benedict A
Credentials DPM, MPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated Jul 8th, 2007 - about 17 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 1356497622 NPPES
Virginia MEDICAID 010265851

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