Basic Information
Provider Information
NPI: 1497850515
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHARFSTEIN
FirstName: BENJAMIN
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MEDICAL PARK BLVD
Address2: 250 WEST
City: BRISTOL
State: TN
PostalCode: 376207430
CountryCode: US
TelephoneNumber: 4238446620
FaxNumber: 4238446627
Practice Location
Address1: 1 MEDICAL PARK BLVD
Address2: 250 WEST
City: BRISTOL
State: TN
PostalCode: 376207430
CountryCode: US
TelephoneNumber: 4238446620
FaxNumber: 4238446627
Other Information
ProviderEnumerationDate: 09/13/2006
LastUpdateDate: 09/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X34037TNY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
388225805TN MEDICAID
26680401TNINDIV ANTHEM/GROUP#093410OTHER
TN010701TNJOHN DEERE NOW UNITED HCOTHER
02227680001TNBLACK LUNG GROUPOTHER
731401905VA MEDICAID
063639801TNUMWA GROUPOTHER
405951401TNBCBS OF TENNESSEEOTHER
P0000732201TNMCRAILROAD/GROUP#CA8128OTHER
703244501TNAETNAOTHER
F0390674801TNCHAMPUS GROUPOTHER


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