Provider Demographics
NPI:1962440628
Name:BENTT, LAVERN K (MD)
Entity Type:Individual
Prefix:
First Name:LAVERN
Middle Name:K
Last Name:BENTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7611 MAPLE AVE
Mailing Address - Street 2:#407
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5559
Mailing Address - Country:US
Mailing Address - Phone:202-378-3307
Mailing Address - Fax:
Practice Address - Street 1:2041 GEORGIA AVE NW HUH B105
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-2306
Practice Address - Country:US
Practice Address - Phone:202-865-6100
Practice Address - Fax:202-865-6713
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY240118207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology