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General NPI Number Information
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NPI Number | 1407144322
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Entity Type | Organization
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Legal Business Name | M. BEHNIA, MD, PC
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 3623 J DEWEY GRAY CIR STE 107
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City | AUGUSTA
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State | GA
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Zip | 30909-6511
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Country | US
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Telephone | 706-869-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 3623 J DEWEY GRAY CIR STE 107
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City | AUGUSTA
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State | GA
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Zip | 30909-6511
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Country | US
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Telephone | 706-869-0710
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEHRDAD BEHNIA
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Credential | M.D.
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Telephone | 706-339-8634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 49611
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License Number State | GA
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