Provider Demographics
NPI:1144237090
Name:BENNETT, SUSAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:K
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:STE 2700N
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-723-5524
Mailing Address - Fax:202-291-0512
Practice Address - Street 1:2131 K ST NW
Practice Address - Street 2:STE 800
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1898
Practice Address - Country:US
Practice Address - Phone:202-822-9356
Practice Address - Fax:202-331-0451
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD30419207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF86301Medicare PIN
MD066MMedicare PIN
DC959142C29Medicare PIN
MDC15430Medicare PIN
DC409629Medicare PIN