Individual
BENJAMIN JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 MEDICAL CENTER DR, BRUNSWICK, ME 04011-2652
(207) 373-6000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
D91702
MD
207L00000X
Anesthesiology Physician
Primary
MD26999
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D91702
LICENSE
MD
01
—
MD26999
LICENSE
ME
Enumeration date
03/27/2017
Last updated
06/22/2023
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