Provider Demographics
NPI:1407097215
Name:BENNETT, STEVEN BRIAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRIAN
Last Name:BENNETT
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:639 CORAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7911
Mailing Address - Country:US
Mailing Address - Phone:757-373-1100
Mailing Address - Fax:
Practice Address - Street 1:472 POLARIS ST BLDG 586
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23461-1935
Practice Address - Country:US
Practice Address - Phone:757-862-0079
Practice Address - Fax:757-862-0082
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2023-09-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical