Individual
DR. BENJAMIN HANSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
19646 N 27TH AVE STE 201, PHOENIX, AZ 85027-4026
(602) 663-9371
(602) 456-6887
Mailing address
19646 N 27TH AVE STE 201, PHOENIX, AZ 85027-4026
(602) 663-9371
(602) 456-6887
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
007813
AZ
208600000X
Surgery Physician
036-137628
IL
208600000X
Surgery Physician
5101018578
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036137628
—
IL
05
—
460209
—
AZ
Enumeration date
08/02/2010
Last updated
03/04/2020
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