Individual
KIMBERLY BENHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403
(812) 353-9515
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
(812) 353-3087
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02004082A
IN
390200000X
Student in an Organized Health Care Education/Training Program
58.003167
OH
Other
Enumeration date
10/05/2009
Last updated
05/24/2023
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