Individual
CHRISTINE A BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
84 MARGINAL WAY, SUITE 1000, PORTLAND, ME 04101-2443
(207) 774-4092
(207) 523-8596
Mailing address
100 FODEN ROAD , WEST, SUITE 203, SOUTH PORTLAND, ME 04106
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
013057
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010928
ANTHEM
—
01
—
1040753
AETNA
—
05
—
218250099
—
ME
Enumeration date
03/18/2006
Last updated
10/14/2010
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