Charles W Bennett MD LLC – Specialist in Lusby, MD

Key facts

NPI: 1477839702
Entity type: Organization (NPI type 2)
Primary specialty: Specialist 174400000X
License: D43306 (MD)
Legal business name: CHARLES W BENNETT MD LLC
Practice address: 11845 HG Trueman Rd
Lusby, MD 20657-2855
Phone: (410) 326-6344
Fax: (410) 326-0079
NPI assigned: Nov 1, 2011
Organization subpart: No

Authorized official

Name: Charles W Bennett
Title: Owner
Phone: (410) 326-6344

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist Group: 193400000X SINGLE SPECIALTY GROUP	174400000X	D43306	MD	Yes

Addresses

Primary practice location

11845 HG Trueman Rd
Lusby, MD 20657-2855

Mailing address

11845 HG Trueman Rd
Lusby, MD 20657-2855

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 1, 2011.

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1477839702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11845 HG TRUEMAN RD",
            "city": "LUSBY",
            "state": "MD",
            "postal_code": "206572855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 HG TRUEMAN RD",
            "city": "LUSBY",
            "state": "MD",
            "postal_code": "206572855",
            "telephone_number": "410-326-6344",
            "fax_number": "410-326-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES W BENNETT MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-326-6344"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D43306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lusby, MD

Calvert County Health Department
Calvert County Health Department
Calvert County Health Department
Calvert Memorial Hospital of Calvert County
Joan Carey
Amanda Diane Cipriani, LCSW-C
Shannon Crush, CD(DONA)
Tolulope Dehinbo, PHARM.D
Sarah Delaney, CLD
Dependable Care

All providers in Lusby, MD · Specialist in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.