Individual
DR. JAYE E BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36060 EUCLID AVE, SUITE 202, WILLOUGHBY, OH 44094-4656
(440) 942-4226
(440) 942-1421
Mailing address
36060 EUCLID AVE, SUITE 202, WILLOUGHBY, OH 44094-4656
(440) 942-4226
(440) 942-1421
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35047445B
OH
207NS0135X
Procedural Dermatology Physician
35047445B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0493854
—
OH
01
—
070000640
RAILROAD MEDICARE
OH
Enumeration date
11/16/2005
Last updated
08/17/2020
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