Provider Demographics
NPI:1134109168
Name:BENJAMIN-SWONGER, MARY K (DPM)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:BENJAMIN-SWONGER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9192 W UNION HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8208
Mailing Address - Country:US
Mailing Address - Phone:602-374-4101
Mailing Address - Fax:602-441-0522
Practice Address - Street 1:333 W THOMAS RD STE 203
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4425
Practice Address - Country:US
Practice Address - Phone:480-931-3887
Practice Address - Fax:480-931-3902
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002772213E00000X
AZ0412213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0939819Medicaid
AZ1679603724Medicaid
OHH176621Medicare PIN