Individual
DR. DEBORAH RAYE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
30880 BECK RD, NOVI, MI 48377
(248) 926-0009
(248) 926-8972
Mailing address
3116 N STOCKTON HILL RD, KINGMAN, AZ 86401-4183
(928) 681-8742
(928) 681-8743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4710
AZ
207Q00000X
Family Medicine Physician
5101009622
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4103599
—
MI
Enumeration date
10/13/2005
Last updated
07/10/2019
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