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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508863051 NPPES
Ohio MEDICAID 0878279
Ohio MEDICAID 1508863051
Ohio MEDICAID 4132886
Ohio MEDICAID 100319490
Ohio Other 130006861

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