Provider Demographics
NPI:1881960227
Name:BENJAMIN, MARTIN AWIYAI (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:AWIYAI
Last Name:BENJAMIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 E THOMPSON PEAK PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7403
Mailing Address - Country:US
Mailing Address - Phone:480-418-5300
Mailing Address - Fax:
Practice Address - Street 1:4611 E SHEA BLVD STE 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4259
Practice Address - Country:US
Practice Address - Phone:602-598-5060
Practice Address - Fax:602-265-6286
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ597542086S0122X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery