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Individual
MARK J BANISTER
Active
Individual
MARK J BANISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
10740
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0RE5597
—
VT
01
—
10740
STATE LICENSE
NH
05
—
3072661
—
NH
Enumeration date
08/03/2006
Last updated
03/07/2023
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