Basic Information
| Provider Information | |||||||||
| NPI: | 1265882674 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EUWER | ||||||||
| FirstName: | BENJAMIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2451 UNIVERSITY HOSPITAL DRIVE | ||||||||
| Address2: | MASTIN BUILDING, ROOM 301 | ||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366171000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514717861 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 19TH ST S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352491000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059343108 | ||||||||
| FaxNumber: | 2059756830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2016 | ||||||||
| LastUpdateDate: | 06/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2016018548 | MO | N | Allopathic & Osteopathic Physicians | Surgery | 2085R0202X | 36847 | AL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 2016018548 | 01 | MO | MISSOURI BOARD OF HEALING ARTS | OTHER |