Individual
EVGENIYA BANINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
304A E 4TH ST, ELDON, MO 65026
(573) 392-5654
(573) 392-5692
Mailing address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019024533
MO
Other
Enumeration date
04/14/2016
Last updated
07/09/2019
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