Banas, Thomas Mark
Banas, Thomas Mark is an individual health care provider with primary practice located at 7956 West Jefferson Blvd , Fort Wayne IN 46804-4159. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Banas, Thomas Mark can be contacted via phone (260) 436-2416.Contact Information
Primary practice address
7956 West Jefferson Blvd
Fort Wayne IN 46804-4159
Phone: (260) 436-2416
Fax: (260) 436-9662
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2020-03917 | North Carolina |
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01040131A | Indiana |
Profile Details
NPI number | 1508863051 |
---|---|
LBN Legal business name | Banas, Thomas Mark |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 30th, 2005 |
Last updated | Oct 23rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1508863051 | NPPES |
Ohio | MEDICAID | 0878279 | |
Ohio | MEDICAID | 1508863051 | |
Ohio | MEDICAID | 4132886 | |
Ohio | MEDICAID | 100319490 | |
Ohio | Other | 130006861 |
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