Provider Demographics
NPI:1265937197
Name:BENGE, MAUREEN CAITLIN (DO)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CAITLIN
Last Name:BENGE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 N SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-4462
Mailing Address - Country:US
Mailing Address - Phone:317-541-3400
Mailing Address - Fax:
Practice Address - Street 1:6002 E 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5614
Practice Address - Country:US
Practice Address - Phone:317-880-6002
Practice Address - Fax:317-880-0417
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN02006238A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program