Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 29385 | AZ |
NPI | 1093788531 |
---|---|
Provider Name | David E Bank |
First Address | Phoenix, AZ 85016-7710 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
597669 | (05) | AZ |
G43180 | (02) | AZ |