Individual
RICHARD M BANOZIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6847 N. CHESTNUT STREET, SUITE 310, RAVENNA, OH 44266
(330) 296-2819
(330) 297-9503
Mailing address
6847 N. CHESTNUT STREET, SUITE 310, RAVENNA, OH 44266
(330) 296-2819
(330) 297-9503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35067230
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0985939
—
OH
01
—
1770896268
TALLMADGE INTERNAL MEDICINE SPECIALISTS
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
09/06/2005
Last updated
12/22/2014
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