Individual
BRIAN BANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 POST OFFICE PARK, WILBRAHAM, MA 01095-1290
(413) 598-7770
(413) 599-1399
Mailing address
70 POST OFFICE PARK, WILBRAHAM, MA 01095-1290
(413) 598-7770
(413) 599-1399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
225181
MA
208000000X
Pediatrics Physician
238726
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110082697/A
—
MA
Enumeration date
04/23/2007
Last updated
03/17/2011
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