Individual
TERRENCE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MSC 07 4040, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-5551
Mailing address
MSC 07 4040, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1215356092
NM
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2014
Last updated
06/07/2014
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