Individual
MISS KIRK G BANERIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 LUDINGTON STREET, ESCANABA, MI 49829-1300
(906) 786-3311
(906) 789-0941
Mailing address
3401 LUDINGTON STREET, ESCANABA, MI 49829-1300
(906) 786-3311
(906) 789-0941
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME76335
FL
2085R0202X
Diagnostic Radiology Physician
Primary
4301048787
MI
2085R0202X
Diagnostic Radiology Physician
ME76335
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016623400
—
FL
01
—
0Q26008
BCN OF MICHIGAN
MI
01
—
0Q26008054
FEDERAL BLACK LUNG
—
01
—
1006439
MCCLAREN
MI
01
—
371664910
HEALTH NET FED SERVICES
—
05
—
4550607
—
MI
01
—
495680
HAP
MI
01
—
P00067927
RR MEDICARE
—
01
—
SJ820005
M-CARE
MI
Enumeration date
10/06/2006
Last updated
10/04/2022
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