Individual
MR. BENTON STOUTAMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
420 CHARTER BLVD STE 402A, MACON, GA 31210-4854
(478) 273-3831
(303) 922-4640
Mailing address
420 CHARTER BLVD STE 402A, MACON, GA 31210-4854
(478) 273-3831
(855) 940-0206
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
10/28/2021
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