Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35.082920 | OH |
NPI | 1013087535 |
---|---|
Provider Name | Kevin Lung-Wong Banks |
First Address | Dublin, OH 43016-4144 |
Second Address | Columbus, OH 43214-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 09/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2639078 | (05) | OH |