Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1900 | ME |
N | 207Q00000X | Family Doctor | 1900 | ME |
NPI | 1003006271 |
---|---|
Provider Name | Dr. Karen M Benezra |
First Address | Kennebunk, ME 04043-0827 |
Second Address | Arundel, ME 04046-8104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 04/01/2022 |