Provider Demographics
NPI:1477288868
Name:BENEDICT, MOLLY (NP-C)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HOWELL MILL RD NW STE 680
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0920
Mailing Address - Country:US
Mailing Address - Phone:404-352-1730
Mailing Address - Fax:
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 680
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0920
Practice Address - Country:US
Practice Address - Phone:404-352-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN290572207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology