Individual
MR. BENJAMIN D SPITALNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4600 WATERS AVE, SAVANNAH, GA 31404-6702
(912) 355-2462
(912) 353-1836
Mailing address
4600 WATERS AVE, SAVANNAH, GA 31404-6274
(912) 355-2462
(912) 353-1836
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
046910
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000865048A
—
GA
01
—
046910
STATE LICENSE
GA
01
—
58-1102392
TAX ID #
GA
01
—
G46910
SC MEDICAID
SC
Enumeration date
09/08/2005
Last updated
03/07/2023
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