Provider Demographics
NPI:1902845530
Name:BENHAM, JANET MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:MICHELLE
Last Name:BENHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:MICHELLE
Other - Last Name:BENHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:29 VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:ME
Mailing Address - Zip Code:04002-7374
Mailing Address - Country:US
Mailing Address - Phone:207-499-7748
Mailing Address - Fax:
Practice Address - Street 1:29 VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:ME
Practice Address - Zip Code:04002-7374
Practice Address - Country:US
Practice Address - Phone:207-499-7748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAA29277OtherHARVARD PILGRIM
ME8856491OtherCIGNA
ME061146OtherANTHEM
MET31548Medicare UPIN
MEAA29277OtherHARVARD PILGRIM