Individual
ALBERT BENNETTE ST. JOHN
Active
Individual
ALBERT BENNETTE ST. JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
11531
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000031289
—
AL
01
—
11531
STATE LICENSE/CONTROLLED
AL
01
—
510-31289ST
BLUE CROSS
AL
Enumeration date
01/23/2008
Last updated
03/07/2023
Update your record
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