Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D0067794 | MD |
Y | 208600000X | Surgeon | D0067794 | MD |
N | 2086S0122X | Plastic and Reconstructive Surgery | D0067794 | MD |
NPI | 1255478533 |
---|---|
Provider Name | Dr. Nia Danielle Banks |
First Address | Lanham, MD 20706-3502 |
Second Address | Lanham, MD 20706-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 30/03/2011 |