Banda, Mary Consolata
Banda, Mary Consolata is an individual health care provider with primary practice located at 100 South St Harrington Physician Services, Inc., Southbridge MA 01550-4051. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Banda, Mary Consolata can be contacted via phone (508) 765-9771.Contact Information
Primary practice address
100 South St Harrington Physician Services, Inc.
Southbridge MA 01550-4051
Phone: (508) 765-9771
Fax: (508) 909-7735
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 75967 | Massachusetts |
Profile Details
| NPI number | 1265481311 |
|---|---|
| LBN Legal business name | Banda, Mary Consolata |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2006 |
| Last updated | Mar 17th, 2018 - about 7 years ago |
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 | 1265481311 | NPPES |
| Massachusetts | MEDICAID | J13190 |
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