| Bbennettmd 1 On 1 Virtual Healthcare | |
|
9159 Bloom Ct Burke VA 22015-1643 | |
| (571) 749-8420 | |
| (855) 955-0445 |
| Full Name | Bbennettmd 1 On 1 Virtual Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 9159 Bloom Ct, Burke, Virginia |
| Authorized Official Name and Position | Elizabeth Ann Bennett (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5717498420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bbennettmd 1 On 1 Virtual Healthcare 9159 Bloom Ct Burke VA 22015-1643 Ph: (571) 749-8420 | Bbennettmd 1 On 1 Virtual Healthcare 9159 Bloom Ct Burke VA 22015-1643 Ph: (571) 749-8420 |
| NPI Number | 1407470107 |
|---|---|
| Provider Enumeration Date | 05/29/2020 |
| Last Update Date | 11/07/2021 |
| Medicare PECOS PAC ID | 3375960875 |
|---|---|
| Medicare Enrollment ID | O20200923000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407470107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710959234 PECOS PAC ID: 2668441726 Enrollment ID: I20040927000636 |
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