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Individual

DR. DANIEL JAMES BENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
12 SPRUCE ST, SUITE #5, AUGUSTA, ME 04330-5204
(207) 626-0100
(207) 626-0800
Mailing address
58 CROSS RD, SOUTH CHINA, ME 04358-4007
(207) 626-0100
(207) 626-0800

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
POD1012
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010539997
TAX ID
ME
01
040971
BLUE CROSS/BLUE SHIELD
ME
05
134580000
ME
Enumeration date
09/08/2005
Last updated
08/06/2012
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