Provider Demographics
NPI:1386963155
Name:METELITS, BENJAMIN S (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:S
Last Name:METELITS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8124 E CACTUS RD STE 410
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5262
Mailing Address - Country:US
Mailing Address - Phone:480-256-2332
Mailing Address - Fax:
Practice Address - Street 1:8124 E CACTUS RD STE 410
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5262
Practice Address - Country:US
Practice Address - Phone:480-256-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ517612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry