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NPI Code Detail

MEDICARE: WYNSTON BENNETT MD

MEDICARE: WYNSTON BENNETT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1891376133
Entity Type Code : Individual
Provider Name (Legal Business Name) : WYNSTON BENNETT MD
Provider Business Mailing Address
First Line : 745 W MOANA LN STE 300
Second Line :
City : RENO
State : NV
Zip : 89509-4980
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 745 W MOANA LN STE 300
Second Line :
City : RENO
State : NV
Zip : 89509-4980
Country : US
Telephone Number : 775-284-9155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2021
Last Update Date : 02/12/2026

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Directions to “ WYNSTON BENNETT MD” Practice Location

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