Provider Demographics
NPI:1598119034
Name:BENJAMIN MUNROE DO PLLC
Entity Type:Organization
Organization Name:BENJAMIN MUNROE DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNROE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-766-0445
Mailing Address - Street 1:5009 E CHARTER OAK RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4186
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5110 N 44TH ST
Practice Address - Street 2:SUITE L200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-1649
Practice Address - Country:US
Practice Address - Phone:602-343-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005952207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty