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:
Health care specialties
| Specialty | Code | License # | 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 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851369755 | NPPES |
| Maryland | MEDICAID | 409551100 | |
| Maryland | MEDICAID | 0011245770006 | |
| Maryland | MEDICAID | 0698428 | |
| Maryland | MEDICAID | 0057577000 | |
| Maryland | MEDICAID | 64113103 |
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