Individual
ANNETTE LOUISE BENNETT-BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 2500, SPARTANBURG, SC 29303-4201
(864) 585-5433
(864) 591-4053
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29899
SC
207R00000X
Internal Medicine Physician
LL29899
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861691487
NPI
SC
05
—
298993
—
SC
01
—
DQ5333
RAILROAD MEDICARE
SC
05
—
GP0077
—
SC
05
—
GP5407
—
SC
01
—
P01505879
RAILROAD MEDICARE
SC
Enumeration date
07/13/2007
Last updated
11/25/2020
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