Individual
MICHAELA S BANCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
002106
NY
207RX0202X
Medical Oncology Physician
104151
MN
207RX0202X
Medical Oncology Physician
Primary
51660
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00771156
RAILROAD MEDICARE
MN
Enumeration date
07/18/2006
Last updated
01/05/2010
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