MEDICARE: ERIC BENNING M.D.

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
1	207R00000X	Internal Medicine Physician	033527	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932196755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC BENNING M.D.

Provider Business Mailing Address
First Line	:	1747 BUCKHEAD VALLEY LN NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-2794
Country	:	US
Telephone Number	:	404-272-6391
Fax Number	:	404-320-3009

Provider Business Practice Location Address
First Line	:	1747 BUCKHEAD VALLEY LN NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-2794
Country	:	US
Telephone Number	:	404-272-6391
Fax Number	:	404-320-3009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	01/20/2016

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Directions to “ ERIC BENNING M.D.” Practice Location

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