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Individual
RICHARD CHARLES BENNETT
Active
Individual
RICHARD CHARLES BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301080053
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06273
BLUE CROSS BLUE SHIELD
MI
01
—
P00761477
RAILROAD MEDICARE
MI
Enumeration date
05/10/2007
Last updated
06/02/2015
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