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Individual
PAUL J. BENNETT
Active
Individual
PAUL J. BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
051867
GA
207R00000X
Internal Medicine Physician
0101247470
VA
208M00000X
Hospitalist Physician
Primary
0101247470
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00980746A
—
GA
05
—
1851305569
—
VA
Enumeration date
07/28/2006
Last updated
02/16/2023
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