Individual
JOHN L BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24035 THREE NOTCH RD, HOLLYWOOD, MD 20636-4871
(301) 373-7900
Mailing address
24035 THREE NOTCH RD, HOLLYWOOD, MD 20636-4871
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0019052
MD
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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