Bennett, Charles P

Bennett, Charles P is an individual health care provider with primary practice located at 430 E Division St , Fond Du Lac WI 54935-4560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bennett, Charles P can be contacted via phone (920) 926-8340.

Contact Information

Primary practice address
430 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-8340
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 48798 Wisconsin

Profile Details

NPI number 1821077801
LBN Legal business name Bennett, Charles P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Dec 4th, 2007 - 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 1821077801 NPPES
Wisconsin MEDICAID 34823000
Wisconsin Other 14559

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