Provider Demographics
NPI:1629963715
Name:BENKE, DYLAN PATRICK (PA-S)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:PATRICK
Last Name:BENKE
Suffix:
Gender:X
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 SISSETON LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8397
Mailing Address - Country:US
Mailing Address - Phone:843-412-1927
Mailing Address - Fax:
Practice Address - Street 1:3761 SISSETON LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8397
Practice Address - Country:US
Practice Address - Phone:843-412-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program