Provider Demographics
NPI:1447588009
Name:STIVERS, BENJAMIN L (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:L
Last Name:STIVERS
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 1:4777 E. GALBRAITH ROAD
Mailing Address - Street 2:DEPT. OF SURGERY
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236
Mailing Address - Country:US
Mailing Address - Phone:513-686-5466
Mailing Address - Fax:513-686-5469
Practice Address - Street 1:4777 E GALBRAITH RD
Practice Address - Street 2:DEPT. OF SURGERY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2725
Practice Address - Country:US
Practice Address - Phone:513-686-5466
Practice Address - Fax:513-686-5469
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.017037208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery