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Individual

CHERIE A BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1201 MICHIGAN AVE, SUITE 170, LOGANSPORT, IN 46947-1580
(574) 722-4331
Mailing address
1201 MICHIGAN AVE, SUITE 170, LOGANSPORT, IN 46947-1580
(574) 722-4331

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01057933A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000300896
ANTHEM
IN
05
200447360
IN
Enumeration date
01/17/2006
Last updated
08/01/2011
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