Individual
RAUL C BANAGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3789
(712) 279-3613
Mailing address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3789
(712) 279-3613
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
21075
IA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
21075
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1149385
—
IA
Enumeration date
03/28/2006
Last updated
12/02/2009
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