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General NPI Number Information
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NPI Number | 1801036538
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Entity Type | Organization
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Legal Business Name | SAMUEL D. BENJAMIN MD, MD(H), PLLC
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 15721 N GREENWAY HAYDEN LOOP #103
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City | SCOTTSDALE
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State | AZ
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Zip | 85260
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Country | US
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Telephone | 480-661-1880
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Fax | 480-661-1890
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Provider Business Mailing Address
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Address Line | 15721 N GREENWAY HAYDEN LOOP #103
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City | SCOTTSDALE
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State | AZ
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Zip | 85260
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Country | US
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Telephone | 480-661-1880
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Fax | 480-661-1890
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMUEL DORIAN BENJAMIN
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Credential | MD
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Telephone | 480-661-1880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13742
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License Number State | AZ
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