Individual
ROGER GUY BANGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5177 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 448-8027
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01039163A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191064
ANTHEM PROVIDER NUMBER
IN
05
—
100232880
—
IN
01
—
10824741
CAQH NUMBER
IN
01
—
9008271
PHCS PID NUMBER
IN
Enumeration date
03/14/2006
Last updated
12/02/2020
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