Provider Demographics
NPI:1437263902
Name:EPSTEIN, BENJAMIN H (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:H
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:678-320-3610
Mailing Address - Fax:678-320-3619
Practice Address - Street 1:6065 PEACHTREE DUNWOODY ROAD
Practice Address - Street 2:SUITE 350
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:678-320-3610
Practice Address - Fax:678-320-3619
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA35044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00483051BMedicaid
GA08BDJQMMedicare ID - Type Unspecified
GAE30232Medicare UPIN