Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 12849 | RI |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD20957 | ME |
NPI | 1316929748 |
---|---|
Provider Name | Dr. Paul Richard Benoit JR. |
First Address | Brewer, ME 04412 |
Second Address | Bangor, ME 04401-1534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 06/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000029140 | BMC HEALTHCARE (01) | MA |
079725 | TUFTS INDIVIDUAL (01) | MA |
172400 | HARVARD PILGRIM INDIVIDUA (01) | MA |
3197531 | (05) | MA |
9716360 | (05) | MA |
H01369 | (02) | MA |