Individual
MR. AUSTIN LOUIS BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
701 CHARLES ST, LA PLATA, MD 20646-5930
(240) 686-2300
(240) 686-2330
Mailing address
2612 PEBBLEBROOK TERRACE CT, WALDORF, MD 20603-3970
(301) 706-1894
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08130
MD
Other
Enumeration date
05/11/2021
Last updated
09/13/2021
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