Provider Demographics
NPI:1477080497
Name:SOUTH ATLANTIC ANESTHESIA SOLUTIONS
Entity Type:Organization
Organization Name:SOUTH ATLANTIC ANESTHESIA SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-749-5800
Mailing Address - Street 1:200 PROVIDENCE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1437
Mailing Address - Country:US
Mailing Address - Phone:704-749-5800
Mailing Address - Fax:
Practice Address - Street 1:200 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9244
Practice Address - Country:US
Practice Address - Phone:336-846-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00727207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty