Individual
DR. DOROTHY H BANISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
67250 INDUSTRY LN, SUITE B, COVINGTON, LA 70433-8716
(985) 893-4711
(985) 893-9094
Mailing address
PO BOX 8865, MANDEVILLE, LA 70470-8865
(985) 893-4711
(985) 893-9094
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
015918
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1349071
—
LA
Enumeration date
11/08/2005
Last updated
12/29/2010
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