Individual
DR. BANNISTER LEE RAINES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 BEDFORD AVE UNIT 21499, BALTIMORE, MD 21282-7525
(443) 415-7170
Mailing address
1325 BEDFORD AVE UNIT 21499, BALTIMORE, MD 21282-7525
(443) 415-7170
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0017735
MD
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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