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Organization
BENJAMIN PHYSICAL MEDICINE, PLC
Active
Organization
BENJAMIN PHYSICAL MEDICINE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT EVAN BENJAMIN MD (OWNER/PHYSICIAN)
(802) 522-9699
Entity
Organization
Contact information
Practice address
373 BLAIR PARK RD, STE 206, WILLISTON, VT 05495-7998
(802) 522-9699
Mailing address
373 BLAIR PARK RD., STE 206, WILLISTON, VT 05495
(802) 522-9699
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
420010625
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0233J1
EMPIRE BC/BS
NY
05
—
02502692
—
NY
05
—
1009844
—
VT
05
—
30204569
—
NH
01
—
3547305
CIGNA
VT
01
—
44146784
CIGNA
NH
01
—
59537
VERMONT BC/BS
VT
01
—
699468
MVP
VT
Enumeration date
04/03/2017
Last updated
04/03/2017
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