Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 5487 | GA |
N | 208600000X | Surgeon | 5487 | GA |
Y | 2086S0120X | Pediatric Surgery | 306910 | NY |
NPI | 1609130533 |
---|---|
Provider Name | Dr. Phillip Benson Ham |
First Address | Buffalo, NY 14203-1009 |
Second Address | Buffalo, NY 14203-1021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 30/10/2020 |