Individual
LORIE DAVIS BENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-AA
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 351-1745
(404) 351-7121
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
005184
GA
367H00000X
Anesthesiologist Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005184
STATE LICENSE
GA
05
—
548553784A
—
GA
Enumeration date
09/24/2007
Last updated
11/07/2016
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