Banker, Michael Wayne

Banker, Michael Wayne is an individual health care provider with primary practice located at 712 Macon Ave , Canon City CO 81212-3314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Banker, Michael Wayne can be contacted via phone (719) 275-8646.

Contact Information

Primary practice address
712 Macon Ave Canon City CO 81212-3314
Phone: (719) 275-8646
Fax: (719) 275-6707
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 27050 Colorado

Profile Details

NPI number 1699848648
LBN Legal business name Banker, Michael Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699848648 NPPES
Colorado MEDICAID 01270503

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