Individual
JOHN V BANTA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 SEYMOUR ST, HARTFORD HOSPITAL, HARTFORD, CT 06102-8000
(860) 545-2791
Mailing address
80 SEYMOUR ST, HARTFORD HOSPITAL, HARTFORD, CT 06102-8000
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
021969
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001219690
—
CT
Enumeration date
02/06/2006
Last updated
05/30/2008
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