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General NPI Number Information
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NPI Number | 1144227885
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Entity Type | Individual
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Provider Name | SARITA L BENNETT DO
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Gender | Female
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | RR 2 BOX 386
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City | MARLINTON
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State | WV
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Zip | 24954-9743
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Country | US
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Telephone | 304-799-0011
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Fax | 304-799-0035
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Provider Business Mailing Address
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Address Line | RR 2 BOX 386
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City | MARLINTON
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State | WV
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Zip | 24954-9743
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Country | US
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Telephone | 304-799-0011
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Fax | 304-799-0035
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1755
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License Number State | WV
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