Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | D0027691 | MD |
NPI | 1114913837 |
---|---|
Provider Name | Dr. James Russell Banks |
First Address | Arnold, MD 21012-1011 |
Second Address | Arnold, MD 21012-1011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 05/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
753481700 | (05) | MD |
D72197 | (02) | MD |