Individual
ANGELA PAIGE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
200001098
NC
2085N0904X
Nuclear Radiology Physician
Primary
200001098
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10005299
—
VA
01
—
1339U
BCBS
NC
05
—
1841917000
—
WV
01
—
7606737
AETNA
NC
01
—
802876
PARTNERS
NC
05
—
891339U
—
NC
01
—
C6266
MEDCOST
NC
05
—
Q98000
—
SC
Enumeration date
12/01/2005
Last updated
01/08/2014
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