Bennett, Mark R

Bennett, Mark R is an individual health care provider with primary practice located at 101 Stadium Dr , Morgantown WV 26506-7911. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bennett, Mark R can be contacted via phone (304) 598-4000.

Contact Information

Primary practice address
101 Stadium Dr Morgantown WV 26506-7911
Phone: (304) 598-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 13482 West Virginia

Profile Details

NPI number 1851369755
LBN Legal business name Bennett, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Nov 5th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851369755 NPPES
Maryland MEDICAID 409551100
Maryland MEDICAID 0011245770006
Maryland MEDICAID 0698428
Maryland MEDICAID 0057577000
Maryland MEDICAID 64113103

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