Individual
SHIRLEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7255 OLD OAK BLVD, #C-202, CLEVELAND, OH 44130-3329
(440) 816-5390
Mailing address
PO BOX 638269, CINCINNATI, OH 45263-0001
(440) 816-5390
(440) 816-6438
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35-055857
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0873309
—
OH
01
—
160017293
RAILROAD MEDICARE PIN
OH
Enumeration date
12/22/2005
Last updated
09/18/2023
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