Individual
PATRICIA BANWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3201 1/2 1ST ST, EMMETSBURG, IA 50536-0000
(712) 852-5555
(712) 852-5560
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 494-3041
(641) 494-3059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02170
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188656
—
IA
01
—
09723
WELLMARK
IA
Enumeration date
08/11/2006
Last updated
07/08/2007
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