Individual
JERRY L BENNETT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2808 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702
Mailing address
2808 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15434
NC
Other
Enumeration date
08/09/2005
Last updated
03/07/2023
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