Healthcare Provider Details

I. General information

NPI: 1750677027
Provider Name (Legal Business Name): BENJAMIN HARRIS NAFZIGER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6046 WHIPPLE AVE NW
NORTH CANTON OH
44720-7616
US

IV. Provider business mailing address

6046 WHIPPLE AVE NW
NORTH CANTON OH
44720-7616
US

V. Phone/Fax

Practice location:
  • Phone: 330-433-1258
  • Fax: 330-433-1506
Mailing address:
  • Phone: 330-433-1258
  • Fax: 330-433-1506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36003677
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: