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Individual

DR. GENIE M BANG

Active
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Individual

DR. GENIE M BANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036131009
IL
207W00000X
Ophthalmology Physician
Primary
054662
CO
207W00000X
Ophthalmology Physician
105521
MN
207W00000X
Ophthalmology Physician
54346
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025513
KAISER COMMERCIAL NUMBER
CO
01
20374
RESIDENT PERMIT
MN
05
26527049
CO
Enumeration date
05/07/2008
Last updated
05/21/2021
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