Individual
DR. LARRY MICHAEL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 WEST BROADWAY, MT PLEASANT, MI 48858
(989) 773-4433
(989) 772-9522
Mailing address
217 WEST BROADWAY, MT PLEASANT, MI 48858
(989) 773-4433
(989) 772-9522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LB050345
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110097379
MEDICARE RR
MI
01
—
1103710492
BCBS
MI
05
—
1134132038
—
MI
Enumeration date
08/14/2006
Last updated
10/20/2016
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