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Individual

DR. JAY BRYAN BANNISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
250 PLEASANT ST, FHC CONCORD, YEAPLE BUILDING, CONCORD, NH 03301-7539
(603) 228-7200
(603) 228-7307
Mailing address
250 PLEASANT ST, FHC CONCORD, YEAPLE BUILDING, CONCORD, NH 03301-7539
(603) 228-7200
(603) 228-7307

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11361
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01YP03530NH02
ANTHEM
01
222594672
PRIVATE HEALTH CARE
NH
05
30201994
NH
01
371511
MVP
NH
01
538777
CIGNA
NH
01
9034053
AETNA
NH
01
AA95518
HARVARD PILGRIM
NH
Enumeration date
05/23/2005
Last updated
05/05/2011
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