Individual
SCOTT M. BENEVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
33 SEWALL ST, PORTLAND, ME 04102-2603
(207) 828-2100
Mailing address
33 SEWALL ST, 33 SEWALL ST, PORTLAND, ME 04102-2603
(207) 828-2101
(207) 553-7166
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA726
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548256035
—
ME
Enumeration date
09/21/2005
Last updated
09/26/2025
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