Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 0101238100 | VA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 167314 | NY |
NPI | 1033157169 |
---|---|
Provider Name | Dr. Michael C Banker |
First Address | Northbrook, IL 60065-0032 |
Second Address | Brooklyn, NY 11235-8014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 12/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010229871 | (05) | VA |
01410860 | (05) | NY |
F54964 | (02) |