Provider Demographics
NPI:1407144322
Name:M. BEHNIA, MD, PC
Entity Type:Organization
Organization Name:M. BEHNIA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHNIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-339-8634
Mailing Address - Street 1:3623 J DEWEY GRAY CIR
Mailing Address - Street 2:STE 107
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6511
Mailing Address - Country:US
Mailing Address - Phone:706-869-0710
Mailing Address - Fax:
Practice Address - Street 1:3623 J DEWEY GRAY CIR
Practice Address - Street 2:STE 107
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6511
Practice Address - Country:US
Practice Address - Phone:706-869-0710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49611207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty