Provider Demographics
NPI:1588653133
Name:BENSON, ELINOR MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ELINOR
Middle Name:MARIA
Last Name:BENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 MARTIN LUTHER KING JR DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-2947
Mailing Address - Country:US
Mailing Address - Phone:404-758-2192
Mailing Address - Fax:404-758-9489
Practice Address - Street 1:991 MARTIN LUTHER KING JR DR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-2947
Practice Address - Country:US
Practice Address - Phone:404-758-2192
Practice Address - Fax:404-758-9489
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052890207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA766021105AMedicaid
GA9441044OtherCIGNA
GA7469680OtherAETNA
GAI28384Medicare UPIN