Provider Demographics
NPI:1255389573
Name:BENCHIK-ABRINKO, PAULA M (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:BENCHIK-ABRINKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 119TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1733
Mailing Address - Country:US
Mailing Address - Phone:219-659-1222
Mailing Address - Fax:219-659-0428
Practice Address - Street 1:1534 119TH ST
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1733
Practice Address - Country:US
Practice Address - Phone:219-659-1222
Practice Address - Fax:219-659-0428
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045436207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110236598OtherRR MEDICARE
IN200119410AMedicaid
188730Medicare PIN
IN200119410AMedicaid