Provider Demographics
NPI:1962592816
Name:BENOIT, CHRISTOPHER PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:BENOIT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 OLD MOUNT HOLLY RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2814
Mailing Address - Country:US
Mailing Address - Phone:843-881-6656
Mailing Address - Fax:
Practice Address - Street 1:588 OLD MOUNT HOLLY RD
Practice Address - Street 2:SUITE G
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2814
Practice Address - Country:US
Practice Address - Phone:843-881-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2681Medicaid
SCGCH147Medicaid
SC7856Medicare ID - Type Unspecified
SCCH2681Medicaid