Individual
TRACEY COLLEEN BANG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-4554
(614) 722-4565
Mailing address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-4554
(614) 722-4565
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35080620
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2497936
—
OH
Enumeration date
07/11/2005
Last updated
07/08/2007
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