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Individual
DR. JOHN MARK BENNETT
Active
Individual
DR. JOHN MARK BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32922
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080115284
MEDICARE RR
NC
01
—
2150033E
MEDICARE PIN
NC
01
—
44365
MEDCOST
SC
05
—
8914885
—
NC
01
—
P01445426
RAILROAD MEDICARE
SC
Enumeration date
01/25/2006
Last updated
11/24/2020
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