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Individual
RICARDO BENNETT
Active
Individual
RICARDO BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
013001009
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258088
ANTHEM
VA
01
—
2700420
UNITED HEALTHCARE
VA
01
—
271860
ANTHEM
VA
01
—
450917
MDIPA
—
01
—
480023439
MEDICARE RR
VA
01
—
480030235
MEDICARE RR
—
01
—
53061
PRINCIPAL
VA
01
—
5963579
AETNA
VA
01
—
71340002
CAREFIRST
—
05
—
9300325
—
VA
01
—
FIRST HEALTH
1077117
VA
Enumeration date
08/27/2006
Last updated
12/18/2012
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