Individual
AVEEN BANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
733 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6101
(715) 838-5222
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
36110170
IL
207W00000X
Ophthalmology Physician
Primary
49886
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34923400
—
WI
Enumeration date
02/15/2006
Last updated
08/24/2009
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