Individual
DR. BUCK BANIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 4TH AVE N, MOORHEAD, MN 56560-2473
(218) 422-7439
Mailing address
2310 4TH AVE N, MOORHEAD, MN 56560-2473
(218) 422-7439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56478
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01249783
RAILROAD MEDICARE
MN
Enumeration date
06/26/2012
Last updated
02/08/2023
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