Anthony a Bennett M D P C

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

AB063302 Issued in MI

Legal business name

ANTHONY A BENNETT M D P C

Doing business as

Advanced Virtual Radiology PLLC

Practice address

29777 Telegraph Rd
Southfield, MI 48034-7625

Phone

(248) 894-8019

Fax

(248) 799-0473

NPI assigned

May 27, 2006

Last updated

Mar 8, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony A Bennett, MDNPI 1801866397

Title

Radiologist

Phone

(248) 894-8019

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Advanced Virtual Radiology PLLC Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Arlo Bennett, MD

  • Diagnostic Radiology Physician
  • Sylvan Lake, MI
  • NPI 1801866397
  Authorized official Same address or phone
• Kim L Travis-Ewing, LMSW

  • Mental Health Counselor
  • Southfield, MI
  • NPI 1659692457
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1316994213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 FRANKLIN WRIGHT BLVD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621585",
            "telephone_number": "248-894-8019",
            "fax_number": "248-799-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29777 TELEGRAPH RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347625",
            "telephone_number": "248-894-8019",
            "fax_number": "248-799-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY A BENNETT M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "248-894-8019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "MI",
            "license": "AB063302",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "AB063302",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MI",
            "license": "AB063302",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "300F392040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Virtual Radiology PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raqibah Ansari
• Nicole Anschutz
• Kazimiera Angeline Anstine
• Kimberly Marie Anstine
• Anthony a Adeleye M. D., P. C.
• Anthony Martin MDMS PC
• Cleo Virginia Anthony
• Kelley Anthony, LLMSW
• Brandon B Anton, DO
• May M Antone, MD

• Diagnostic Radiology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.