Individual
STEVEN I BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
117 S MAIN ST, ANN ARBOR, MI 48104-1902
(734) 665-5306
(734) 930-2383
Mailing address
117 S MAIN ST, ANN ARBOR, MI 48104-1902
(734) 665-5306
(734) 930-2383
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002604
MI
152WC0802X
Corneal and Contact Management Optometrist
4901002604
MI
152WL0500X
Low Vision Rehabilitation Optometrist
4901002604
MI
152WP0200X
Pediatric Optometrist
4901002604
MI
152WX0102X
Occupational Vision Optometrist
4901002604
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2675077
—
MI
01
—
SB002604
BCBS MICHIGAN
MI
Enumeration date
08/23/2005
Last updated
02/08/2013
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