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Individual

JOHN BENNET II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
26040 DETROIT RD, SUITE 7, WESTLAKE, OH 44145-2481
(440) 871-1717
(440) 871-3098
Mailing address
26040 DETROIT RD, SUITE 7, WESTLAKE, OH 44145-2481
(440) 871-1717
(440) 871-3098

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35 056333
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0875236
OH
Enumeration date
09/12/2006
Last updated
06/10/2011
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