Individual
KATHRYN EMMA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, FRCPC
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3023
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301102143
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/15/2011
Last updated
01/31/2014
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