Individual
DR. JONATHAN E. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
A.I. DUPONT HOSPITAL FOR CHILDREN, 1600 ROCKLAND ROAD, WILMINGTON, DE 19803-3607
(302) 651-4000
(302) 651-4945
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
BB5890163
DE
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
C10006685
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001948563
—
PA
05
—
01973899
—
NY
05
—
200056380
—
OK
05
—
4002661
—
MD
05
—
8947503
—
NJ
Enumeration date
09/28/2006
Last updated
02/10/2016
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