Healthcare Provider Details

I. General information

NPI: 1851590186
Provider Name (Legal Business Name): BENJAMIN DANE CAHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1499 FAIR RD
STATESBORO GA
30458
US

IV. Provider business mailing address

7 ACEE DRIVE
NATRONA HEIGHTS PA
15065
US

V. Phone/Fax

Practice location:
  • Phone: 912-486-1636
  • Fax:
Mailing address:
  • Phone: 800-223-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036172769
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number062102
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: