Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | L1613 | TX |
NPI | 1023085925 |
---|---|
Provider Name | Sabrina M Benefield |
First Address | Belfast, ME 04915-4085 |
Second Address | Longview, TX 75605-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
165498003 | (05) | TX |
H35621 | (02) | TX |