Provider Demographics
NPI:1053361402
Name:KESSLER, BENJAMIN J (DO)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:J
Last Name:KESSLER
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 1:25 HOSPITAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2738
Mailing Address - Country:US
Mailing Address - Phone:843-689-8141
Mailing Address - Fax:843-689-8112
Practice Address - Street 1:25 HOSPITAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2738
Practice Address - Country:US
Practice Address - Phone:843-689-8141
Practice Address - Fax:843-689-8112
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC600207R00000X
GA45851207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG85434Medicare UPIN