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Individual

DR. MICHAEL A BANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2400 HOSPITAL DR, STE. 250, BOSSIER CITY, LA 71111-2385
(318) 746-4460
(318) 746-3389
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8951
(318) 212-6752

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.09177R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1493651
LA
Enumeration date
06/21/2005
Last updated
06/17/2021
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