# BENJAMIN DAVID FANGMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417451162
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | T0201 | TX | — |
| 207RH0003X | Hematology & Oncology Physician | 2024024367 | MO | Yes |
| 207RH0003X | Hematology & Oncology Physician | T0201 | TX | — |

## Other

- **Enumeration date:** 03/19/2018
- **Last updated:** 07/22/2024