Individual
BENNETT IRA FEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
319 HOSPITAL DR, SUITE 103, MARTINSVILLE, VA 24112-1929
(276) 666-0044
(276) 666-0393
Mailing address
319 HOSPITAL DR, SUITE 103, MARTINSVILLE, VA 24112-1929
(276) 666-0044
(276) 666-0393
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101243894
VA
207RG0100X
Gastroenterology Physician
200401498
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033265848
—
VA
05
—
5900806
—
NC
Enumeration date
01/25/2007
Last updated
05/26/2011
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