Individual
RICARDO BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
8704 ROLLING RD, MANASSAS, VA 20110-4253
(703) 361-3132
(703) 368-0291
Mailing address
8704 ROLLING RD, MANASSAS, VA 20110-4253
(703) 361-3132
(703) 368-0291
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
013001009
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258088
ANTHEM
VA
01
—
2700420
UNITED HEALTHCARE
VA
01
—
271860
ANTHEM
VA
01
—
450917
MDIPA
—
01
—
480023439
MEDICARE RR
VA
01
—
480030235
MEDICARE RR
—
01
—
53061
PRINCIPAL
VA
01
—
5963579
AETNA
VA
01
—
71340002
CAREFIRST
—
05
—
9300325
—
VA
01
—
FIRST HEALTH
1077117
VA
Enumeration date
08/27/2006
Last updated
12/18/2012
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