Individual
DR. MICHAEL WAYNE BANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
712 MACON AVE, CANON CITY, CO 81212-3314
(719) 275-8646
(719) 275-6707
Mailing address
712 MACON AVE, CANON CITY, CO 81212-3314
(719) 275-8646
(719) 275-6707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27050
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01270503
—
CO
Enumeration date
11/16/2006
Last updated
07/08/2007
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