Individual
DR. SEAN ROBERT BENNETT
Active
Individual
DR. SEAN ROBERT BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD
Taxonomy
Speciality
Code
Description
License number
State
261QR1100X
Research Clinic/Center
Primary
0101240200
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101242200
MEDICAL LICENSE
VA
Enumeration date
08/01/2019
Last updated
08/01/2019
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