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NPI Code Detail

MEDICARE: ERIC BENJAMIN MD

MEDICARE: ERIC BENJAMIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician2483AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639148950
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC BENJAMIN MD
Provider Business Mailing Address
First Line : 3807 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-5005
Country : US
Telephone Number : 602-258-6797
Fax Number : 602-258-1134
Provider Business Practice Location Address
First Line : 3807 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-5005
Country : US
Telephone Number : 602-258-6797
Fax Number : 602-258-1134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/21/2011

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Directions to “ ERIC BENJAMIN MD” Practice Location

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