Provider Demographics
NPI:1710057302
Name:BENOIT, JOSEPH LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LAWRENCE
Last Name:BENOIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:700 MOUNT HOPE AVE
Mailing Address - Street 2:SUITE 480
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5691
Mailing Address - Country:US
Mailing Address - Phone:207-990-1615
Mailing Address - Fax:207-990-5997
Practice Address - Street 1:700 MOUNT HOPE AVE
Practice Address - Street 2:SUITE 480
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5691
Practice Address - Country:US
Practice Address - Phone:207-990-1615
Practice Address - Fax:207-990-5997
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME011974207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME127240099Medicaid
D03571Medicare UPIN
ME127240099Medicaid