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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972598704 NPPES
Other 043684279011 BLUE CROSS BLUE SHIELD
MEDICAID 31847300 BLUE CROSS BLUE SHIELD

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