Healthcare Provider Details

I. General information

NPI: 1518959006
Provider Name (Legal Business Name): ERIK T. BENDIKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11650 ALPHARETTA HWY SUITE 100
ROSWELL GA
30076
US

IV. Provider business mailing address

11650 ALPHARETTA HWY SUITE 100
ROSWELL GA
30076
US

V. Phone/Fax

Practice location:
  • Phone: 404-596-5670
  • Fax: 770-338-9103
Mailing address:
  • Phone: 404-596-5670
  • Fax: 770-338-9103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number051866
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number051866
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: