Provider Demographics
NPI:1093926040
Name:SPINNER, BENJAMIN A (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:A
Last Name:SPINNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29425 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4639
Mailing Address - Country:US
Mailing Address - Phone:216-292-0610
Mailing Address - Fax:
Practice Address - Street 1:29425 CHAGRIN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4639
Practice Address - Country:US
Practice Address - Phone:216-292-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1256312084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry