Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 5901002120 | MI |
Y | 222Z00000X | Podiatrist | 5901002120 | MI |
N | 213ES0103X | Foot & Ankle Surgery | 5901002120 | MI |
NPI | 1073519047 |
---|---|
Provider Name | Dr. William Michael Bennett |
First Address | Sterling Heights, MI 48312 |
Second Address | Sterling Heights, MI 48312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 29/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000010955 | CAPE HEALTH PLAN (01) | MI |
024862 | MIDWEST HEALTH PLAN (01) | MI |
138116 | CARE CHOICES (01) | MI |
157017 | GREAT LAKES HEALTH PLAN (01) | MI |
200826048 | UNITED HEALTHCARE (01) | MI |
4618712 | MOLINA (01) | MI |
4927665 | (05) | MI |
5209654 | (05) | MI |
540E020630 | BCBSM DME SUPPLIER ID (01) | MI |
5501280 | BCBSM (01) | MI |
7928302 | AETNA (01) | MI |
DOL/WORKERS COMP | 611794800 (01) | MI |
P00433820 | RAILROAD MEDICARE (01) | MI |
P00459715 | RAILROAD MEDICARE (01) | MI |
U85210 | (02) | MI |
U85210 | HEALTH ALLANCE PLAN (01) | MI |