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Individual
MICHAEL P BANNON
Active
Individual
MICHAEL P BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29516
MN
2086S0127X
Trauma Surgery Physician
Primary
29516
MN
Other
Enumeration date
02/20/2006
Last updated
08/12/2020
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