Craig Howard Bennett (NPI# 1992743702, PAC ID# 3072401751) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1992743702 |
| PAC ID by PECOS | 3072401751 |
| Professional Enrollment ID | I20040304001328 |
| Full Name | Craig Howard Bennett |
| Organization Legal Name | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| Address |
10084 Reisterstown Rd Suite 300a Owings Mills MD 21117-4160 |
| Phone Number | 6672196313 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, CALIFORNIA COLLEGE OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Secondary Specialties | SPORTS MEDICINE |
| Group Practice PAC ID | 3678751468 |
| Number of Group Practice Members | 105 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210058 | UNIV OF MD REHABILITATION & ORTHOPAEDIC INSTITUTE |
| 210040 | NORTHWEST HOSPITAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10084 Reisterstown Rd, Suite 300a, Owings Mills, MD 21117-4160 | 6672196313 | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| Organization Legal Name | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| Physicians | 109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen Witanowski | Internal Medicine | Lifebridge Community Physicians Inc | 410 Malcolm Dr, Suite A, Westminster, MD 21157-6160 |
| Kimberly S Weiss | Physician Assistant | Lifebridge Community Physicians Inc | 6355 Ten Oaks Rd, Suite 202, Clarksville, MD 21029-1185 |
| Sam A Zamaria | Obstetrics/gynecology | Lifebridge Community Physicians Inc | 118 Shawan Rd, Suite 220, Cockeysville, MD 21030-1318 |
| Ronald L Broadwater Sr. | General Practice | Lifebridge Community Physicians Inc | 688 Poole Rd, Westminster, MD 21157-6166 |
| Ruchira N Thakor | Family Medicine | Lifebridge Community Physicians Inc | 4 W Rolling Crossroads, Suite 100, Catonsville, MD 21228-6280 |
| Charles Phillip Adamo | Family Medicine | Lifebridge Community Physicians Inc | 2629 Riva Rd, Suite 112, Annapolis, MD 21401-7428 |
| Prema Siva | Internal Medicine | Lifebridge Community Physicians Inc | 8871 Gorman Rd, Laurel, MD 20723-5877 |
| Cyrus Hamidi | Family Medicine | Lifebridge Community Physicians Inc | 913 Ridgebrook Rd, Suite 312, Sparks, MD 21152-9457 |
| Elvira Pasmanik | Internal Medicine | Lifebridge Community Physicians Inc | 8600 Liberty Rd, Randallstown, MD 21133-4707 |
| Alexander Bogdaschewskyi | Internal Medicine | Lifebridge Community Physicians Inc | 1011 Baltimore Blvd, Westminster, MD 21157-7055 |
| Street Address |
10084 REISTERSTOWN RD SUITE 300A |
| City | OWINGS MILLS |
| State | MD |
| Zip | 21117-4160 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel D Poliakoff | Pediatric Medicine | 10084 Reisterstown Rd, Suite 200b, Owings Mills, MD 21117-4096 | |
| Kristen Allard | Nurse Practitioner | Lifebridge Community Physicians Inc | 10084 Reisterstown Rd, Owings Mills, MD 21117-4093 |
| Latrica K Cook | Internal Medicine | Lifebridge Community Physicians Inc | 10084 Reisterstown Rd, Owings Mills, MD 21117-4093 |
| Alex Phillip Schultz | Physician Assistant | Lifebridge Community Physicians Inc | 10084 Reisterstown Rd, Suite 300a, Owings Mills, MD 21117-4160 |
| Jay Steven Orr | Family Medicine | Lifebridge Community Physicians Inc | 10084 Reisterstown Rd, Owings Mills, MD 21117-4093 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeremy P Goldman | Optometry | 12621 Waterspout Ct, Owings Mills, MD 21117-1028 | |
| Brian M Granek | Optometry | 10995 Owings Mills Blvd, Suite 204, Owings Mills, MD 21117-1030 | |
| Yves Joseph Jr. | Physical Therapy | Maryland Sportscare and Rehab LLC | 10995 Owings Mills Blvd, Suite 210, Owings Mills, MD 21117-1030 |
| Daniel Sparks | Physical Therapy | Maryland Sportscare and Rehab LLC | 10995 Owings Mills Blvd, Suite 210, Owings Mills, MD 21117-1030 |
| Terryle Lee Williams | Clinical Social Worker | 22 Birch Bark Ct, Owings Mills, MD 21117-1319 | |
| Lakeia D Allen | Clinical Social Worker | 417 Doe Meadow Dr, Owings Mills, MD 21117-1367 | |
| Shneur Z Marshall | Clinical Social Worker | Jewish Community Services Inc | 3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409 |
| Malya Levin | Clinical Social Worker | Jewish Community Services Inc | 3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409 |
| Rachael S Abrams | Clinical Social Worker | Jewish Community Services Inc | 3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409 |
| Rosa Perez | Clinical Social Worker | Jewish Community Services Inc | 3506 Gwynnbrook Ave, Owings Mills, MD 21117-1409 |
| Find all physicians in zip 21117 | |||
| City | OWINGS MILLS |
| Zip Code | 21117 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | OWINGS MILLS + ORTHOPEDIC SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.