Provider Demographics
NPI:1902531791
Name:JAMESON, BENJAMIN (MSPO, CP)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:JAMESON
Suffix:
Gender:M
Credentials:MSPO, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 ASHLEY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5305
Mailing Address - Country:US
Mailing Address - Phone:843-936-1642
Mailing Address - Fax:
Practice Address - Street 1:1407 ASHLEY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5305
Practice Address - Country:US
Practice Address - Phone:843-936-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty