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General NPI Number Information
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NPI Number | 1013988708
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Entity Type | Individual
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Provider Name | DR. STEVEN WESLEY BENNETT
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 2414 PENNSYLVANIA AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-1722
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Country | US
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Telephone | 443-447-1661
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Fax | 410-466-2154
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Provider Business Mailing Address
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Address Line | 3300 ROYAL FERN WAY
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City | WINDSOR MILL
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State | MD
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Zip | 21244-1164
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Country | US
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Telephone | 443-447-1661
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Fax | 410-466-2154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01235
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License Number State | MD
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