Provider Demographics
NPI:1013915552
Name:ATKESON, BENJAMIN GRANGER (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:GRANGER
Last Name:ATKESON
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 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4110
Mailing Address - Fax:
Practice Address - Street 1:2076 NC HIGHWAY 42 W
Practice Address - Street 2:100
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5302
Practice Address - Country:US
Practice Address - Phone:919-359-0322
Practice Address - Fax:919-359-0326
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701232207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-11728Medicaid
NC89-11728Medicaid
NCG82994Medicare UPIN
NC2026365CMedicare PIN