Individual
SUHAIL M BANISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 SCHAEFER RD, DEARBORN, MI 48126-3698
(313) 581-2600
(313) 581-0228
Mailing address
5701 HARTWELL ST, APT. 305, DEARBORN, MI 48126-2200
(313) 584-0532
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301067035
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3225612
—
MI
01
—
350Q264320
BCBSM
MI
Enumeration date
01/23/2006
Last updated
02/23/2012
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