Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD029365E | PA |
NPI | 1083600498 |
---|---|
Provider Name | Jeffrey Brian Banyas |
First Address | Weirton, WV 26062-5058 |
Second Address | Weirton, WV 26062-5055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 15/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001302386 | HIGHMARK (01) | |
0015479020006 | (05) | PA |
040009191 | RAILROAD MEDICARE (01) | |
101108 | FEDERAL BLACK LUNG (01) | |
101731 | UPMC (01) | PA |
1035617 | GATEWAY (01) | PA |
546944 | BLUE SHIELD (01) | |
61301 | MEDPLUS (01) | PA |
D72744 | (02) |