Crocker, Benjamin

Crocker, Benjamin is an individual health care provider with primary practice located at 208 Vaughan St , Portland ME 04102-3204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Crocker, Benjamin can be contacted via phone (207) 450-8627.

Contact Information

Primary practice address
208 Vaughan St Portland ME 04102-3204
Phone: (207) 450-8627
Fax: (888) 290-0232
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X G043952 California
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD13127 Maine

Profile Details

NPI number 1841297009
LBN Legal business name Crocker, Benjamin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2005
Last updated Feb 2nd, 2016 - about 9 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 1841297009 NPPES
Maine MEDICAID 273470099

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