# BRUCE BANIAS MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesis Obstetrics & Gynecology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699966325
- **Authorized official:** DR. BRUCE BLAND BANIAS MD (PHYSICIAN BUSINESS OWNER)
- **Authorized official phone:** (932) 293-5200

## Contact information

- **Practice address:** 3075 GOVERNORS PLACE BLVD, SUITE 210, DAYTON, OH 45409-1323
- **Practice address phone:** (937) 293-5200
- **Practice address fax:** (937) 424-5925
- **Mailing address:** 3075 GOVERNORS PLACE BLVD, SUITE 210, DAYTON, OH 45409-1323
- **Mailing address phone:** (937) 293-5200
- **Mailing address fax:** (937) 424-5925

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 35052271 | OH | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | 3562520C | OH | — |

## Other

- **Enumeration date:** 08/07/2007
- **Last updated:** 08/07/2007