Individual
SCOTT J. BANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12655 WARWICK BLVD, NEWPORT NEWS, VA 23606-2501
(757) 595-9880
(757) 595-0362
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8777
(757) 232-8866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101048645
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102024
UHC
VA
01
—
080127507
RR/MEDICARE
—
01
—
233415
MAMSI PROV #
VA
01
—
250450
ANTHEM PROVIDER NUMBER
VA
05
—
5606225
—
VA
Enumeration date
06/14/2005
Last updated
03/19/2021
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