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Individual

DR. BRADLEY HOLMES BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4701 RANDOLPH RD, SUITE 203, ROCKVILLE, MD 20852-2257
(301) 681-6437
(301) 681-0975
Mailing address
4701 RANDOLPH RD, SUITE 203, ROCKVILLE, MD 20852-2257
(301) 681-6437
(301) 681-0975

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
D0026752
MD
208C00000X
Colon & Rectal Surgery Physician
MD11630
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D0026752
LICENSE
MD
01
M11630
LICENSE
DC
Enumeration date
08/30/2006
Last updated
10/16/2012
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