Healthcare Provider Details

I. General information

NPI: 1831200401
Provider Name (Legal Business Name): BENJAMIN DAVIES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 CENTRE AVE SUITE 209
PITTSBURGH PA
15232-1300
US

IV. Provider business mailing address

5200 CENTRE AVE SUITE 209
PITTSBURGH PA
15232-1300
US

V. Phone/Fax

Practice location:
  • Phone: 412-605-3020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA94247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: