Individual
SEAN CONSTANTINE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3010 15TH AVE S, GREAT FALLS, MT 59405-5240
(406) 454-2171
(303) 306-7753
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
(850) 416-7619
(850) 416-7753
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102204833
VA
207R00000X
Internal Medicine Physician
36048
MT
207R00000X
Internal Medicine Physician
Primary
OS11339
FL
208M00000X
Hospitalist Physician
0102204833
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003779100
—
FL
01
—
OS11339
FLORIDA MEDICAL LICENSE
FL
Enumeration date
06/20/2011
Last updated
06/28/2024
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