Individual
FERAS J BANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-8880
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
67.000404
OH
367H00000X
Anesthesiologist Assistant
Primary
75000156A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102495798
ANTHEM PTAN
IN
Enumeration date
03/09/2021
Last updated
07/22/2026
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