MEDICARE: DR. BENNETT I MACHANIC M.D.

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
1	2084N0400X	Neurology Physician	20000	CO

General Provider Information

NPI Number	:	1952352593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENNETT I MACHANIC M.D.

Provider Business Mailing Address
First Line	:	3955 E EXPOSITION AVE
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80209-5000
Country	:	US
Telephone Number	:	720-583-1754
Fax Number	:	720-941-8894

Provider Business Practice Location Address
First Line	:	3955 E EXPOSITION AVE
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80209-5000
Country	:	US
Telephone Number	:	720-583-1754
Fax Number	:	720-941-8894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	06/14/2016

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