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Individual

LAURENCE WALN BEHNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01043611A
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01043611A
IN
207R00000X
Internal Medicine Physician
01043611A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01043611A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000027961
M PLAN
IN
01
000000341213
ANTHEM
IN
01
01043611B
CSR
IN
01
10780253
CAQH
IN
Enumeration date
01/22/2007
Last updated
03/07/2023
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