Banham, Ivona M
Banham, Ivona M is an individual health care provider with primary practice located at 2700 Quarry Lake Dr Ste 300 , Baltimore MD 21209-3746. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Banham, Ivona M can be contacted via phone (410) 768-5555.Contact Information
Primary practice address
2700 Quarry Lake Dr Ste 300
Baltimore MD 21209-3746
Phone: (410) 768-5555
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | C0000856 | Maryland |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | C00856 | Maryland |
Profile Details
NPI number | 1598726978 |
---|---|
LBN Legal business name | Banham, Ivona M |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 28th, 2006 |
Last updated | May 24th, 2022 - about 2 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 | 1598726978 | NPPES |
Maryland | Other | P00141770 | R/R MEDICARE PROVIDER # |
Maryland | Other | CN6601 | R/R MEDICARE PROVIDER # |
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