Individual
DR. SUDESHNA BANERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3311 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 97477-8800
(541) 484-4332
Mailing address
3311 RIVERBEND DR, SUITE 300, SPRINGFIELD, OR 97477-8800
(541) 484-4332
(541) 242-6770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.008712
OH
207RI0011X
Interventional Cardiology Physician
Primary
MD155880
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093926081
NPI
—
01
—
57.008712
OHIO TEMPORARY LICENSE
OH
Enumeration date
05/24/2007
Last updated
03/03/2016
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