Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 09858 | GA |
NPI | 1609993260 |
---|---|
Provider Name | Peter W Benoit |
First Address | Atlanta, GA 30327-4111 |
Second Address | Atlanta, GA 30327-4111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |