Provider Demographics
NPI:1326337940
Name:BENNETT, DAVID M (MD)
Entity Type:Individual
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First Name:DAVID
Middle Name:M
Last Name:BENNETT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7 CAMBRIDGE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4763
Mailing Address - Country:US
Mailing Address - Phone:203-335-0195
Mailing Address - Fax:203-335-7293
Practice Address - Street 1:900 MADISON AVE STE 209
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606
Practice Address - Country:US
Practice Address - Phone:203-335-0195
Practice Address - Fax:203-335-7293
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2022-02-21
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Provider Licenses
StateLicense IDTaxonomies
CT55084207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1326337940Medicaid