Individual
DR. ANTHONY ARLO BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036112710
IL
2085R0202X
Diagnostic Radiology Physician
AB063302
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3009301771
BCBSM
MI
01
—
700H219330
BLUE CROSS
MI
01
—
AB063302
LICENSE
MI
01
—
MI3594001
PTAN
MI
Enumeration date
01/25/2006
Last updated
11/13/2023
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