Individual
JOHN A BANZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2011 NW MYHRE PL, SILVERDALE, WA 98383-8561
(360) 830-1601
(360) 830-1696
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00044888
WA
207RC0000X
Cardiovascular Disease Physician
Primary
MD00044888
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193177
LABOR & INDUSTRIES
WA
01
—
3867363
AETNA
—
01
—
7533BA
REGENCE BLUESHIELD
—
05
—
8424863
—
WA
01
—
P00245670
RAILROAD MEDICARE
—
Enumeration date
06/25/2006
Last updated
03/07/2023
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