Basic Information
| Provider Information | |||||||||
| NPI: | 1427052240 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENEDICT | ||||||||
| FirstName: | FREDERICK | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 WAKE FOREST RD STE 220 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276096864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198725296 | ||||||||
| FaxNumber: | 9198509718 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 WAKE FOREST RD STE 220 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276096864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198725296 | ||||||||
| FaxNumber: | 9198509718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2005 | ||||||||
| LastUpdateDate: | 01/08/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 32339 | NC | N | Other Service Providers | Specialist | 207X00000X | 32339 | NC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.