Provider Demographics
NPI:1194266965
Name:UMBEL, BENJAMIN DAVID (DO)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:DAVID
Last Name:UMBEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 WENDY LN
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1660
Mailing Address - Country:US
Mailing Address - Phone:330-501-1755
Mailing Address - Fax:
Practice Address - Street 1:503 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5104
Practice Address - Country:US
Practice Address - Phone:828-437-6500
Practice Address - Fax:828-330-0930
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-03073207X00000X, 207XX0004X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program