Individual
DR. KRISTA MAUREEN BANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
441 S LIVERNOIS RD STE 260, ROCHESTER HILLS, MI 48307-2593
(248) 855-5355
Mailing address
300 RIVERFRONT DR, UNIT 11B, DETROIT, MI 48226-4516
(312) 282-3182
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301092722
MI
Other
Enumeration date
06/26/2008
Last updated
03/28/2019
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