Individual
DR. MICHAEL J BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3400 CIVIC CENTER BLVD, ARC ROOM 716G, PHILADELPHIA, PA 19104-4306
(215) 590-3394
Mailing address
3400 CIVIC CENTER BLVD, ARC ROOM 716G, PHILADELPHIA, PA 19104-4306
(215) 590-3394
(215) 590-1998
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
25MS00011000
NJ
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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