Provider Demographics
NPI:1508157561
Name:SIATU'U, BENJAMIN DAVE (MBBS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DAVE
Last Name:SIATU'U
Suffix:
Gender:M
Credentials:MBBS
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Mailing Address - Street 1:1 DR PAUL TURNER DRIVE
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799
Mailing Address - Country:US
Mailing Address - Phone:684-633-1222
Mailing Address - Fax:684-633-1839
Practice Address - Street 1:1 DR PAUL TURNER DRIVE
Practice Address - Street 2:
Practice Address - City:PAGO PAGO
Practice Address - State:AS
Practice Address - Zip Code:96799
Practice Address - Country:US
Practice Address - Phone:684-633-1222
Practice Address - Fax:684-633-1839
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2024-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AS4048A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology