Organization
LARRY BENNETT MEDICAL L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY M BENNETT M.D. (OWNER)
(989) 773-4433
Entity
Organization
Contact information
Practice address
217 W BROADWAY ST, MT PLEASANT, MI 48858-2576
(989) 773-4433
(989) 772-9522
Mailing address
217 W BROADWAY ST, MT PLEASANT, MI 48858-2576
(989) 773-4433
(989) 772-9522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093896029
—
MI
01
—
1103710492
BCBSM
MI
Enumeration date
10/18/2006
Last updated
10/18/2023
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