Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 01047400A | IN |
N | 208600000X | Surgeon | 01047400A | IN |
N | 2086S0102X | Surgical Critical Care | D0070559 | TN |
Y | 2086S0102X | Surgical Critical Care | ME124502 | FL |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 0104700A | IN |
NPI | 1053482141 |
---|---|
Provider Name | Dr. Donald Richard Bennett |
First Address | North Bethesda, MD 20852-5800 |
Second Address | Bethesda, MD 20889-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 24/10/2019 |