Individual
DR. ANGELA M BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5264 LEE RD, MAPLE HEIGHTS, OH 44137-1232
(216) 294-4440
(216) 249-6032
Mailing address
5264 LEE RD, MAPLE HEIGHTS, OH 44137-1232
(216) 294-4440
(216) 249-6032
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-088523
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2719071
—
OH
01
—
4203042
MEDICARE PTAN
OH
Enumeration date
05/31/2005
Last updated
08/25/2023
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