Individual
DR. MICHAEL JON BENOIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2528 WHEATON WAY, SUITE 105, BREMERTON, WA 98310-3305
(360) 373-0303
Mailing address
2528 WHEATON WAY, SUITE 105, BREMERTON, WA 98310-3305
(360) 373-0303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00017979
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1343607
—
WA
01
—
162223100000
PREMERA
—
01
—
17005
L & I
WA
01
—
BE5062
REGENCE
WA
Enumeration date
09/06/2006
Last updated
12/14/2007
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