Organization
BENJAMIN B MASSENBURG IV MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN B MASSENBURG IV MD (PRESIDENT)
(805) 563-3011
Entity
Organization
Contact information
Practice address
221 MAHALANI ST, WAILUKU, HI 96793-2526
(808) 242-2290
Mailing address
PO BOX 8488, PHILADELPHIA, PA 19101-8488
(805) 563-3011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05627502
—
HI
Enumeration date
02/22/2008
Last updated
07/24/2009
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