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Contact Information

WAYNE D BENTHAM, MD
3640 TALMAGE CIR STE 216
VADNAIS HEIGHTS, MN55110-7100
 Phone: 952-431-5330
 Fax: 952-431-5334
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychosomatic Medicine

2084P0015X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for WAYNE D BENTHAM · (Male)

NPI # 1609952407
Status Active
Credentials MD
Entity Individual
Enumeration date 10/27/2006
Last updated 02/28/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 68407
  • WI License # 62533-20
  • AR Medicaid 214692001
  • MO Medicaid 1609952407
  • WA Medicaid 1609952407
  • Other 276890 INTERNAL ID-MOTOR VEHICLE ID
  • WA Other 0186104 L&I
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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