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Individual
MICHAEL DOUGLAS BENNETT
Active
Individual
MICHAEL DOUGLAS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.004487
OH
363A00000X
Physician Assistant
Primary
PA2067
KY
Other
Enumeration date
10/16/2015
Last updated
12/05/2023
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