Individual
BRIAN JOSEPH BANSIDHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4125 W RIDGE RD, ERIE, PA 16506-1763
(814) 833-1119
(814) 833-1138
Mailing address
4125 W RIDGE RD, ERIE, PA 16506-1763
(814) 833-1119
(814) 833-1138
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
OS-010801L
PA
Other
Enumeration date
10/05/2006
Last updated
04/07/2016
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