Individual
BRIAN CHARLES BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3821 ED DR, RALEIGH, NC 27612-8038
(919) 851-5482
(919) 859-1729
Mailing address
3821 ED DR, RALEIGH, NC 27612-8038
(919) 851-5482
(919) 859-1729
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
9500827
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14792
BLUECROSSBLUESHIELD
NC
05
—
89133GF
—
NC
Enumeration date
01/27/2006
Last updated
01/22/2014
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