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Individual

DR. SHANTE D BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
503 NORTH 21ST ST, CAMP HILL, PA 17011
(717) 972-4379
(717) 972-4640
Mailing address
100 NORTH ACADEMY AVE, DANVILLE, PA 17822-4903
(717) 972-4379
(717) 972-4640

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD463798
PA
208600000X
Surgery Physician
MT200201
PA

Other

Enumeration date
01/02/2013
Last updated
10/01/2018
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