Organization
ANTHONY A BENNETT M D P C
Active
Other names
Advanced Virtual Radiology PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY A BENNETT MD (RADIOLOGIST)
(248) 894-8019
Entity
Organization
Contact information
Practice address
29777 TELEGRAPH RD, SOUTHFIELD, MI 48034-7625
(248) 894-8019
(248) 799-0473
Mailing address
441 FRANKLIN WRIGHT BLVD, LAKE ORION, MI 48362-1585
(248) 894-8019
(248) 799-0473
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
AB063302
MI
2085R0202X
Diagnostic Radiology Physician
Primary
AB063302
MI
2085U0001X
Diagnostic Ultrasound Physician
AB063302
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300F392040
BCBS
MI
Enumeration date
05/27/2006
Last updated
03/08/2011
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