Individual
ELIZABETH ANN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9159 BLOOM CT, BURKE, VA 22015-1643
(571) 749-8420
(855) 955-0445
Mailing address
9159 BLOOM CT, BURKE, VA 22015-1643
(571) 749-8420
(855) 955-0445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101236782
VA
Other
Enumeration date
02/07/2006
Last updated
11/07/2021
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