Individual
STEVEN BENNETT
Active
Individual
STEVEN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R77905
AZ
207R00000X
Internal Medicine Physician
R77905
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R77905
ARIZONA MEDICAL BOARD
AZ
Enumeration date
04/18/2020
Last updated
05/05/2021
Update your record
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