Individual
DR. PEDRO M. BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2311 N PROSPECT AVE, MILWAUKEE, WI 53211-4445
(414) 319-3000
(414) 319-3087
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 319-3000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
45820
WI
Other
Enumeration date
10/05/2005
Last updated
06/07/2012
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