Organization
RETINA ASSOCIATES, PLLC
Active
Other names
North Carolina Retina Associates, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL K BENNETT MD (OWNER)
(919) 782-8038
Entity
Organization
Contact information
Practice address
4414 LAKE BOONE TRL, STE 302, RALEIGH, NC 27607-7513
(919) 782-8038
(919) 782-8189
Mailing address
4414 LAKE BOONE TRL STE 302, RALEIGH, NC 27607-7514
(919) 782-8038
(919) 782-8189
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014T8
BCBS-GROUP
NC
01
—
2333843
MEDICARE-GROUP
NC
05
—
89014T8
—
NC
01
—
DB4007
RR MEDICARE-GROUP
NC
Enumeration date
07/15/2006
Last updated
02/28/2022
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