Individual
LLOYD J BANASZAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2855 CAMPUS DR, SUITE 400, PLYMOUTH, MN 55441-2659
(612) 577-7400
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
277997
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
987570100
—
MN
Enumeration date
05/08/2006
Last updated
11/04/2011
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