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NPI Code Detail

MEDICARE: CARMEN MARIE BENOIT P.A.

MEDICARE: CARMEN MARIE BENOIT P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5299GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15299OTHERGAMEDICAL LICENSE

General Provider Information

NPI Number : 1467628024
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN MARIE BENOIT P.A.
Provider Business Mailing Address
First Line : 21 ORTHO LN
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2315
Country : US
Telephone Number : 404-778-6379
Fax Number : 404-251-5897
Provider Business Practice Location Address
First Line : 21 ORTHO LN
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2315
Country : US
Telephone Number : 404-778-6379
Fax Number : 404-251-5897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2008
Last Update Date : 01/25/2024

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