Individual
JOHN M BANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
605 OAK ST, BIG RAPIDS, MI 49307-2048
(616) 364-4200
Mailing address
14278 PARALLEL AVE, ALPENA, MI 49707-8537
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301072825
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500410472
BLUE CROSS BLUE SHIELD MI
MI
05
—
4452016
—
MI
Enumeration date
10/11/2006
Last updated
02/14/2020
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