Benham, Sean Thomas
Benham, Sean Thomas is an individual health care provider with primary practice located at 1765 N 18Th St , Manitowoc WI 54221-0997. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Benham, Sean Thomas can be contacted via phone (920) 482-0575.Contact Information
Primary practice address
1765 N 18Th St
Manitowoc WI 54221-0997
Phone: (920) 482-0575
Fax: (920) 482-0579
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 33608020 | Wisconsin |
Profile Details
| NPI number | 1972598704 |
|---|---|
| LBN Legal business name | Benham, Sean Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972598704 | NPPES |
| Other | 043684279011 | BLUE CROSS BLUE SHIELD | |
| MEDICAID | 31847300 | BLUE CROSS BLUE SHIELD |
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