Individual
RAYMOND ANTHONY BANNAN
Active
Individual
RAYMOND ANTHONY BANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16474
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095458000
—
WV
01
—
180012368
RAILROAD MEDICARE
WV
01
—
DG8768
RAILROAD MEDICARE GROUP
WV
Enumeration date
12/06/2006
Last updated
02/18/2020
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