Individual
CHARLES WILLIAM BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 884-3004
Mailing address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 884-3004
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
MD2016-0080
NM
208D00000X
General Practice Physician
Primary
MD2016-0080
NM
Other
Enumeration date
08/09/2007
Last updated
11/07/2024
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