Individual
THOMAS MARK BANAS
Active
Individual
THOMAS MARK BANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01040131A
IN
2084N0400X
Neurology Physician
2020-03917
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0878279
—
OH
05
—
100319490
—
IN
01
—
130006861
RR MEDICARE
IN
05
—
1508863051
—
NC
05
—
4132886
—
MI
Enumeration date
06/30/2005
Last updated
10/23/2023
Update your record
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