Individual
MRS. JUSTINA A BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
85 THOMAS JOHNSON CT, SUITE C, INTERNAL MEDICINE SPECIALISTS OF FREDERICK, FREDERICK, MD 21702
(301) 668-9393
(301) 668-4480
Mailing address
85 THOMAS JOHNSON CT, SUITE C, FREDERICK, MD 21702
(301) 668-9393
(301) 668-4480
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0003652
MD
363AM0700X
Medical Physician Assistant
C03652
MD
Other
Enumeration date
11/27/2007
Last updated
05/10/2017
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