Provider Demographics
NPI:1881948974
Name:BENNETT, HUGH MARSHALL I (DC)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:MARSHALL
Last Name:BENNETT
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:HUGH
Other - Middle Name:MARSHALL
Other - Last Name:BENNETT
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5209 COCHRAN RD
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8735 PLANTATION LN
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4506
Practice Address - Country:US
Practice Address - Phone:703-992-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor