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Individual

DR. MARK ALLAN BENAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4350 TOWNE CENTRE DR STE 2000, EVANS, GA 30809-3331
(706) 854-3333
(706) 854-2179
Mailing address
729 HAMPTON, MONROE, GA 30655-2083
(770) 266-0541

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
048976
GA
208600000X
Surgery Physician
Primary
48976
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00900611A
GA
Enumeration date
10/18/2005
Last updated
04/05/2024
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