Provider Demographics
NPI:1750543815
Name:BENOIT, STEPHEN R (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:BENOIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1600 CLIFTON RD NE
Mailing Address - Street 2:MS E-03
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30333
Mailing Address - Country:US
Mailing Address - Phone:404-639-5013
Mailing Address - Fax:
Practice Address - Street 1:3367 BUFORD HWY NE
Practice Address - Street 2:SUITE 910
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-1833
Practice Address - Country:US
Practice Address - Phone:678-843-8700
Practice Address - Fax:404-633-0502
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0596002083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine